Derick Phillip, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD037403E Issued in PA

Practice address

Old Oxford Highway 75 Lsci
Federal Correctional Complex
Butner, NC 27509

Phone

(919) 575-5000

Fax

(919) 575-5061

NPI assigned

Oct 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1881946952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 999",
            "address_2": "FEDERAL CORRECTIONAL COMPLEX",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "27509",
            "telephone_number": "919-575-5000",
            "fax_number": "919-575-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OLD OXFORD HIGHWAY 75 LSCI",
            "address_2": "FEDERAL CORRECTIONAL COMPLEX",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "27509",
            "telephone_number": "919-575-5000",
            "fax_number": "919-575-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIP",
        "first_name": "DERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD037403E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard J Peckman, PHARMD
• Susan Saik Peebles, M.D.
• Demelza Mary Pengelly, MSW, LCSW, LCAS-A
• Laquinta Perry, MSW, LCSW
• Brandon Phelps
• Erin M Piechocinski, PSY.D.
• Sandra French Pillow, MSW, LCSW
• Gary Brian Pohl, M.D.
• Kermit Maurice Poole, LCSW
• Janey Lynn Pope, MD

• Internal Medicine Physician in Butner, NC
• Providers in Butner, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.