Mark T Phillips, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001989 Issued in VA

Practice address

8700 Sudley Road
Prince William Hospital
Manassas, VA 20110

Phone

(703) 369-8337

Fax

(703) 369-8868

NPI assigned

Jul 26, 2006

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)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1912920232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20010 CENTURY BLOULEVARD",
            "address_2": "SUITE 200",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741106",
            "telephone_number": "240-686-2300",
            "fax_number": "240-686-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 SUDLEY ROAD",
            "address_2": "PRINCE WILLIAM HOSPITAL",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-369-8337",
            "fax_number": "703-369-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thu Thien Pham, MD
• Nina Phatak, MD
• Phi Health, LLC
• Phi, Inc.
• Libby Beatty Phillips
• Phoenix Counseling Services
• Physical Medicine Associates, LTD
• Physiotherapy Associates Inc
• Nicole Piazza, M.S., CF-SLP
• Michael Vincent Piccinino, D.D.S.

• Physician Assistant in Manassas, VA
• Providers in Manassas, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.