Active NPI
James Lee Phillips, DO
- Pediatrics Physician
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2009016967
- Practice address
- 4331 S. Fremont
Springfield, MO 65804 - Phone
- (417) 820-5000
- Fax
- (417) 820-5015
- NPI assigned
- Oct 4, 2006
- Last updated
- Sep 19, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R-7924 | IA | |
| Pediatrics Physician | 208000000X | 2009016967 | MO | Primary |
Addresses
Primary practice location
4331 S. Fremont
Springfield, MO 65804
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | TRICARE WEST | |
| 1982799763 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-7924 | IA | MD | Pediatrics Physician |
| 2009016967 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Hospital Springfield | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
4331 S Fremont Ave
Springfield, MO 65804
Phone (417) 820-5000
Interoperability endpoints
- jphillips101116@directc.mercy.net
- jphillips91083@directb.mercy.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
dba Mercy Clinic Family Medicine-Willow Springs
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1982799763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4331 S. FREMONT",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "65804",
"telephone_number": "417-820-5000",
"fax_number": "417-820-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JAMES",
"middle_name": "LEE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IA",
"license": "R-7924",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2009016967",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE WEST",
"identifier": "431560263",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1982799763",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.