Jacob Isaiah Phillips, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0810006313 Issued in VA

Practice address

1604 Hilltop West Ctr Ste 216
Virginia Beach, VA 23451-6131

Phone

(757) 498-9585

Fax

(757) 468-1685

NPI assigned

Apr 12, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1922532308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 HILLTOP WEST CTR STE 216",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516131",
            "telephone_number": "757-498-9585",
            "fax_number": "757-468-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 HILLTOP WEST CTR STE 216",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516131",
            "telephone_number": "757-498-9585",
            "fax_number": "757-468-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JACOB",
        "middle_name": "ISAIAH",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810006313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Wayne Phillips
• Cristen Nicole Phillips, DMD
• Danielle Phillips
• Derek Michael Phillips, PHARMD
• Georgia Phillips, LCSW
• Janiya T Phillips, LPC
• Jillian Marie Phillips
• Joshua Phillips, LPC-R
• Sharay M Phillips
• Steven B Phillips, DPT

• Clinical Neuropsychologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Neuropsychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.