James William Phillippi, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0-0363 Issued in ID

Practice address

263 N Woodruff Ave
Suite a
Idaho Falls, ID 83401

Phone

(208) 542-4433

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• James William Brook Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2014 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1912120544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 N WOODRUFF AVE",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-542-4433",
            "fax_number": "888-450-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 N WOODRUFF AVE",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-542-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPPI",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O 0363",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "0-0363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "BROOK",
            "middle_name": "WILLIAM",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wendell E Petty, M.D.
• Douglas Frank Pfister, ASLD
• Pharmacy Care Consultants
• Emily Phenix
• Molly Susan Phillipp, C.R.N.P.
• Caleb Milton Phillips
• Gabriel Phillips, PHARMD
• Renee Phillips
• Taylor Mark Phillips
• Physician Skin Care

• Family Medicine Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.