Active NPI
Dustin Dewells Phillips, NP
- Family Nurse Practitioner
- Bishopville, SC
National Provider Identifier
1962906248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 21623
- Practice address
- 990 Wisacky Hwy # NA
Bishopville, SC 29010-1775 - Phone
- (803) 428-2800
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21623 | SC | Primary |
Addresses
Primary practice location
990 Wisacky Hwy # NA
Bishopville, SC 29010-1775
Mailing address
990 Wisacky Hwy
Bishopville, SC 29010-1775
Phone (803) 428-2800
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21623 | SC | MD | Family Nurse Practitioner |
Interoperability endpoints
- dustin.phillips.p1@direct.scdc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1962906248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 WISACKY HWY",
"city": "BISHOPVILLE",
"state": "SC",
"postal_code": "290101775",
"telephone_number": "803-428-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 WISACKY HWY # NA",
"city": "BISHOPVILLE",
"state": "SC",
"postal_code": "290101775",
"telephone_number": "803-428-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "DUSTIN",
"middle_name": "DEWELLS",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-21",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "21623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bishopville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.