MISTY M. PHILLIPS (NPI# 1053461657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053461657 |
| Entity Type | Individual |
| Full Name | MISTY M. PHILLIPS |
| Credential | M.D. |
| Practice Address |
2532 Farragut Dr Springfield IL 62704-1433 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036117503 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036117503 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851956510 | Misty Phillips | Speech-Language Pathologist | 101 Bulldog Dr, Plumerville, AR 72127-8803 | 2019-05-07 |
| 1417098740 | Misty Phillips | Counselor | 2535 Kettner Blvd Ste 1a4, San Diego, CA 92101-1252 | 2007-02-09 |
| Street Address |
2532 FARRAGUT DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-1433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376529917 | Penny S. Fricke | Clinical Nurse Specialist | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2005-12-15 |
| 1316330582 | Leslie K Farris | Nurse Practitioner | 2532 Farragut Dr, Springfield, IL 62704 | 2015-03-12 |
| 1649436809 | Purvi Patel Bhandari | Pediatrics | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2008-08-06 |
| 1093973182 | Springfield Pediatric & Adolescent Ctr Lab | Clinical Medical Laboratory | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2008-05-27 |
| 1013126317 | Claudine Gillison | Pediatrics | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2007-05-22 |
| 1184795940 | Gretchen Suzanne Gibbs | Pediatrics | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2006-11-13 |
| 1003917089 | Stephanie E. Wojtowicz | Pediatrics | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2006-09-25 |
| 1548360134 | Stephen E. Wallace | Pediatrics | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2006-09-23 |
| 1023118718 | Susan M. Soler | Pediatrics | 2532 Farragut Dr, Springfield, IL 62704-1433 | 2006-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074492 | Kinnera Are | Pediatrics | 400 N 9th St Ste 4a, Springfield, IL 62702-5310 | 2020-05-13 |
| 1306208368 | Mckenzie Smith | Pediatrics | 2115 S Fremont Ave Ste 2900, Springfield, MO 65804-2233 | 2016-03-28 |
| 1790181402 | Sonam Verma | Pediatrics | 400 N 9th St # 4a, Springfield, IL 62702-5310 | 2014-11-06 |
| 1619382132 | Eric D Mcfeely | Pediatrics | 280 Chestnut Street, 2nd Floor, Springfield, MA 01199-1001 | 2014-06-23 |
| 1073923231 | Charlotte Mcknight | Pediatrics | 6120 Brandon Ave Ste 308, Springfield, VA 22150-2504 | 2014-04-28 |
| 1336437078 | Rashmi Jain | Pediatrics | 1965 S Fremont Ave Ste 260, Springfield, MO 65804-2257 | 2011-07-15 |
| 1861785958 | Sienna Vorono Winer | Pediatrics | 6501 Loisdale Ct., Springfield, VA 22150 | 2011-05-23 |
| 1649581570 | Kendra Suzanne Woods | Pediatrics | 415 N 9th St Ste 2w126, Springfield, IL 62702-5303 | 2010-06-25 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1417105024 | Stephen Edward Saunders | Pediatrics | 5 Orchard Ln, Springfield, IL 62712-8911 | 2008-09-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
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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.