DR. BENJAMIN E PHILLIPS (NPI# 1003808676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003808676 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN E PHILLIPS |
| Credential | M.D. |
| Practice Address |
164 N Broadway Green Bay WI 54303-2728 |
| Practice Telephone | 9209654055 |
| Mailing Telephone | 9209654055 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2015-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 44214-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | ADMINASTAR FEDERAL | 0376640002 | 01 |
| WI | 34181000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912443516 | Benjamin Phillips Iv | Peer Specialist | 2015 Nw 19th St, Oklahoma City, OK 73106-1605 | 2017-01-06 |
| 1326359720 | Benjamin G. Phillips | Dentist | 1048 Union St, Suite 4, Bangor, ME 04401-8600 | 2010-06-30 |
| 1225256043 | Benjamin Z Phillips | Plastic Surgery | 1 High St, Wakefield, RI 02879-3103 | 2007-04-24 |
| 1275678021 | Benjamin William Phillips | Internal Medicine | 180 S Main St, Canton, IL 61520-2608 | 2007-02-20 |
| 1841281995 | Benjamin R. Phillips | Surgery | 1100 Walnut St, Mob, 5th Floor, Philadelphia, PA 19107-5563 | 2005-10-28 |
| Street Address |
164 N BROADWAY |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-2728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932410461 | Ngassa A Mssika | Physician Assistant | 164 N Broadway, Green Bay, WI 54303-2728 | 2010-06-30 |
| 1710142237 | Jordan Elizabeth Toman | Radiology | 164 N Broadway, Green Bay, WI 54303-2728 | 2008-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487703880 | Wisconsin Oculoplastics Ltd | Ophthalmology | 1525 Park Pl, Green Bay, WI 54304-1979 | 2007-01-09 |
| 1215039136 | Kurt August Schwiesow | Ophthalmology | 1087 W Mason Street, Green Bay, WI 54303-1859 | 2006-09-01 |
| 1356367023 | James Edward Memmen | Ophthalmology | 1543 Park Pl, Suite 400, Green Bay, WI 54304-1970 | 2006-07-14 |
| 1992731327 | Marie D Nassiff | Ophthalmology | 4665 Wery Rd, Green Bay, WI 54311-9102 | 2006-06-25 |
| 1790720100 | Dianna L Bordewick | Ophthalmology | 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 | 2006-06-19 |
| 1659336733 | Matthew J Thompson | Ophthalmology | 1087 W Mason St, #1, Green Bay, WI 54303-1859 | 2006-04-20 |
| 1316932197 | Pamela G Dobson | Ophthalmology | 211 N Broadway, Ste 103, Green Bay, WI 54303-2757 | 2005-09-16 |
| 1326042730 | Daniel L Dale | Ophthalmology | 1525 Park Place, Green Bay, WI 54304-1979 | 2005-06-13 |
| 1134440670 | William Joseph Reynders | Ophthalmology | 2253 W Mason St, Green Bay, WI 54303 | 2010-06-18 |
| 1841440138 | Dongmei Chen | Ophthalmology | 2253 W Mason St, Green Bay, WI 54303-4706 | 2008-09-24 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.