Individual provider Active NPI

Brandon Lane Phillips, MD

  • Pediatric Cardiology Physician
  • West Monroe, LA
National Provider Identifier
1881893808
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
303412 Issued in LA
Practice address
300 Pavilion Rd
West Monroe, LA 71292-9470
Phone
(318) 323-1100
NPI assigned
Jul 11, 2007
Last updated
Nov 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X N5944 TX
Pediatric Cardiology Physician 2080P0202X 303412 LA Primary

Addresses

Primary practice location

300 Pavilion Rd
West Monroe, LA 71292-9470

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other practice location 1

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 323-1100

Other identifiers 2

IdentifierTypeStateIssuer
09731876MedicaidMS
2430718MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bphillips64344@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170203000553 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 8921199068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
303412LAMDPediatric Cardiology Physician
N5944TXMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Sep 26, 2016 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Sep 26, 2016 Accepting new patients
Terry D. King, MD AMC Pediatric Cardiology PastSince May 1, 2009 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1881893808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PAVILION RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712929470",
            "telephone_number": "318-323-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712017407",
            "country_code": "US",
            "telephone_number": "318-323-1100",
            "fax_number": "318-323-1161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BRANDON",
        "middle_name": "LANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "N5944",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "LA",
            "license": "303412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09731876",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2430718",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bphillips64344@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bphillips64344@direct.casso.us.com",
            "address_1": "309 Jackson St",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "309 Jackson St",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.