RILEY PHILLIPS (NPI# 1073079125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073079125 |
| Entity Type | Individual |
| Full Name | RILEY PHILLIPS |
| Credential | PA-C |
| Practice Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012685660 |
| Practice Fax Number | 6015795240 |
| Mailing Telephone | 6012685660 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2020-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07821201 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891313839 | Riley Makenna Phillips | Speech-Language Pathologist | 970 Calle Amanecer Ste A, San Clemente, CA 92673-6250 | 2020-07-07 |
| 1700380318 | Riley Phillips | Community/Behavioral Health | 541 Main St Ste 303, South Weymouth, MA 02190-1845 | 2018-03-19 |
| Street Address |
415 S 28TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-7246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225030372 | Norman Blake Moore Jr. | Nurse Anesthetist, Certified Registered | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2005-06-01 |
| 1457950842 | Tyler Griffin Armstrong | Nurse Anesthetist, Certified Registered | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2020-10-19 |
| 1538776679 | Hattiesburg Clinic, Pa | Clinic/Center | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2020-09-23 |
| 1205446804 | Robert Price Ledbetter | Perfusionist | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2020-08-07 |
| 1972143626 | Jarrod Edward Gant | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7283 | 2020-01-10 |
| 1720625841 | Corey Lyle Gambrell | Nurse Anesthetist, Certified Registered | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-12-09 |
| 1447802103 | Heather Pritchett Bassi | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-07-12 |
| 1891357588 | Dylan Winston Boyd | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-07-02 |
| 1578124186 | Casie Barnes | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-06-25 |
| 1992364491 | Stacy Louise Neames | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7283 | 2019-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316419575 | Kaylon Ann Kilpatrick | Physician Assistant | 421 S 28th Ave Ste 110, Hattiesburg, MS 39401-7208 | 2018-12-27 |
| 1649880543 | Allison Joy Finch | Physician Assistant | 5909 U S Highway 49, Hattiesburg, MS 39402-2860 | 2020-08-05 |
| 1649735135 | Carter Graham Holland | Physician Assistant | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-02-08 |
| 1013490317 | Lauren Marie Worley | Physician Assistant | 6051 U S Highway 49, Hattiesburg, MS 39401-7200 | 2018-09-12 |
| 1346768819 | Hamilton Fredrick Stevens | Physician Assistant | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2017-09-06 |
| 1720524648 | Samantha Jones | Physician Assistant | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2017-01-17 |
| 1215395306 | Allison Henderson | Physician Assistant | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2016-02-03 |
| 1215354691 | Lauren English | Physician Assistant | 102 Medical Park, Hattiesburg, MS 39401 | 2014-03-24 |
| 1063848075 | Rowdy Chance Lee | Physician Assistant | 103 Medical Park, Hattiesburg, MS 39401-9042 | 2013-09-23 |
| 1972841419 | Patricia Edwards Donahue | Physician Assistant | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2013-01-17 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
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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.