Individual provider Active NPI

Christopher E Phillips, PAC

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1891706867
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50002339 Issued in OH
Practice address
4235 Secor Rd
Toledo, OH 43623-4231
Phone
(419) 479-5820
Fax
(419) 479-5821
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2339 OH
Physician Assistant 363A00000X 50002339 OH Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4231

Mailing address

4235 Secor Rd
Toledo, OH 43623
Phone (419) 479-5820

Other identifiers 1

IdentifierTypeStateIssuer
0236248MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061004000440 OH Practitioner - Physician Assistant 1951307560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

303 Chestnut Commons Dr
Elyria, OH 44035-9607
Phone (440) 366-9444

450 Avon Belden Rd
Avon Lake, OH 44012-2282
Phone (440) 930-6800

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
  • Lutheran Hospital Hospital, Cleveland, OH, CCN 360087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50002339OHMDPhysician Assistant
2339OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jun 4, 2013 Accepting new patients

Locations

450 Avon Belden Rd
Avon Lake, OH 44012
Phone (440) 930-6800

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

Organizations & group practices 1

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1891706867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43623",
            "telephone_number": "419-479-5820",
            "fax_number": "440-988-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5820",
            "fax_number": "419-479-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CHRISTOPHER",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "2339",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236248",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.