Active NPI
Mary S Phillips, M.D.
- Surgery Physician
- Morehead, KY
National Provider Identifier
1912925660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 27207
- Practice address
- 425 Clinic Dr
Morehead, KY 40351-1077 - Phone
- (606) 784-7551
- Fax
- (606) 780-2373
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 27207 | KY | Primary |
Addresses
Primary practice location
425 Clinic Dr
Morehead, KY 40351-1077
Mailing address
425 Clinic Dr
Morehead, KY 40351-1077
Phone (606) 784-1049
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64272073 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proudfoot & Associates, PSC | Surgery | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423526400000",
"number": "1912925660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 CLINIC DR",
"city": "MOREHEAD",
"state": "KY",
"postal_code": "403511077",
"telephone_number": "606-784-1049",
"fax_number": "606-783-1099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 CLINIC DR",
"city": "MOREHEAD",
"state": "KY",
"postal_code": "403511077",
"telephone_number": "606-784-7551",
"fax_number": "606-780-2373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MARY",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2015-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "27207",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64272073",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morehead, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.