Roger Alan Phillips, MD

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

4301047365 Issued in MI

Practice address

270 Hoover Blvd
Holland, MI 49423-3719

Phone

(616) 396-2972

Fax

(616) 396-2808

NPI assigned

Jun 10, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Odyssey Healthcare Operating B, LP

  • Community Based Hospice Care Agency
  • Grand Rapids, MI
  • NPI 1528347572

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1922049600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-396-2972",
            "fax_number": "616-396-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-396-2972",
            "fax_number": "616-396-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ROGER",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "4301047365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1739680",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pgpa LLC
• Dennis Hieu Pham, PHARMD
• Phares Family Dentistry
• Earl Knowles Phares Jr., DDS
• Thomas Chase Phares, DDS
• Physiotherapy Associates Inc
• Physiotherapy Associates, Inc
• Abbey Mikala Pierce
• Laurel Jeanne Pierce, LMSW
• Timothy Piers, LLMSW

• Hospice and Palliative Medicine (Internal Medicine) Physician in Holland, MI
• Providers in Holland, MI by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.