Individual provider Active NPI

Danny C Phipps, DOCTOR OF MINISTRY

  • Counselor
  • Shallotte, NC
National Provider Identifier
1982909214
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
531 Issued in NC
Practice address
632 Village Rd Ste 1
Shallotte, NC 28470-3434
Phone
(910) 754-5727
Fax
(910) 754-5797
NPI assigned
Jan 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 531 NC
Counselor 101Y00000X 531 NC Primary

Addresses

Primary practice location

632 Village Rd Ste 1
Shallotte, NC 28470-3434

Mailing address

632 Village Rd # Box
Shallotte, NC 28470-3435
Phone (910) 754-5727

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

State licenses

LicenseStateTypeSpecialty
531NCMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
The Bridge of the Carolinas Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1982909214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 VILLAGE RD # BOX",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703435",
            "telephone_number": "910-754-5727",
            "fax_number": "910-754-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 VILLAGE RD STE 1",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703434",
            "telephone_number": "910-754-5727",
            "fax_number": "910-754-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "DANNY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DOCTOR OF MINISTRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-18",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "531",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.