Phoenix Provider Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PHOENIX PROVIDER SERVICES LLC

Practice address

1509 Dulles Dr
Lafayette, LA 70506-3718

Phone

(337) 991-9276

Fax

(337) 991-9288

NPI assigned

Oct 20, 2015

Organization subpart

No

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

Authorized official

Name

Nicole Howard

Title

Manager

Phone

(337) 991-9276

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1942672720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PROVIDER SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Ruth Phillips, MD
• Evan Phillips, PA
• Meggan Phillips, LPC
• Rusty Lane Phillips, LCSW
• Phoebe N Glorias Counseling LLC
• Physical Medicine Center
• Physical Therapy Advantage
• Physical Therapy Clinic of Lafayette, Inc.
• Physical Therapy Clinic of Lafayette, LLC
• Physical Therapy South, Inc

• Psychiatric/Mental Health Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.