Sally Lee Phillips, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN.448686 Issued in OH

Practice address

960 Boardman Canfield Rd
Boardman, OH 44512-4220

Phone

(330) 953-3300

NPI assigned

Apr 17, 2017

Last updated

Oct 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sally Lee Phillips-Soares Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1942734926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124220",
            "telephone_number": "330-953-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124220",
            "telephone_number": "330-953-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SALLY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.448686",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.150607.MEDS-IV",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "PHILLIPS-SOARES",
            "middle_name": "LEE",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mario Petrino
• Peter J Petroff
• Jennifer Rebecca Petruska, NNP
• Vincent J Peyko Jr.
• Jasmine R Phillips, CDCA, OCPSA, QMHS
• Taylor James Phillips
• Pauline Phung, D.O.
• Physicians Diagnostic & Rehabilitation Center Inc
• Physicians Dialysis Company Inc. (Physicians Dialysis Center Boardman)
• Cara Picciano

• Registered Nurse in Boardman, OH
• Providers in Boardman, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.