Organization Active NPI

Russell E. Phillips, M.D., P.C.

  • Psychiatry Physician
  • Wynnewood, PA
National Provider Identifier
1881887115
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD015455E Issued in PA
Legal business name
RUSSELL E. PHILLIPS, M.D., P.C.
Practice address
31 Lankenau Medical BLDG. West
100 Lancaster Avenue
Wynnewood, PA 19096-3450
Phone
(610) 896-5710
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Russell E. Phillips, M.D.
Title
President
Phone
(610) 896-5710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD015455E PA Primary

Addresses

Primary practice location

31 Lankenau Medical BLDG. West
100 Lancaster Avenue
Wynnewood, PA 19096-3450

Mailing address

31 Lankenau Medical BLDG. West
100 Lancaster Avenue
Wynnewood, PA 19096-3450
Phone (610) 896-5710

National Provider Directory

National Provider Directory

Locations

100 E Lancaster Ave
Ste 415
Wynnewood, PA 19096
Phone (610) 642-6292

31 Lankenau Medical Bldg W
#100
Wynnewood, PA 19096
Phone (610) 896-5710

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1881887115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LANKENAU MEDICAL BLDG. WEST",
            "address_2": "100 LANCASTER AVENUE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-896-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LANKENAU MEDICAL BLDG. WEST",
            "address_2": "100 LANCASTER AVENUE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-896-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL E. PHILLIPS, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-896-5710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD015455E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.