DR. RANDALL JOSEPH PHILLIPS (NPI# 1124099395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124099395 |
| Entity Type | Individual |
| Full Name | DR. RANDALL JOSEPH PHILLIPS |
| Credential | MD |
| Practice Address |
5001 Us Highway 30 W Ste D Fort Wayne IN 46818-9701 |
| Mailing Address |
Po Box 80070 Fort Wayne IN 46898-0070 |
| Practice Telephone | 2604321568 |
| Practice Fax Number | 2604324969 |
| Mailing Telephone | 2604321568 |
| Mailing Fax Number | 2604324969 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2016-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01042709 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1124099395 | 05 | |
| IN | 100389260 | 05 | |
| OH | 2038280 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104083997 | Randall Jerald Phillips | Dentist | 516 Candler St, Gainesville, GA 30501-3332 | 2008-05-20 |
| 1154304962 | Randall Phillips | Radiology | 2780 Middle Country Rd Ste 210, Lake Grove, NY 11755-2120 | 2005-11-25 |
| 1851662860 | Randall Austin Phillips Jr. | Social Worker | 301 Nw 63rd St, Suite 301, Oklahoma City, OK 73116-7907 | 2012-01-23 |
| 1295763183 | Randall R Phillips | Otolaryngology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2006-06-29 |
| 1841248705 | Randall Phillips | Physical Therapist | 96 Macon Center Dr, Franklin, NC 28734-6779 | 2006-05-04 |
| 1306848940 | Randall Wallace Phillips | Marriage & Family Therapist | 367b N Parkway, Jackson, TN 38305-2865 | 2005-08-12 |
| Street Address |
5001 US HIGHWAY 30 W STE D |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46818-9701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447250188 | Richard B Collins | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2005-07-22 |
| 1205190147 | Jonathan C Lee | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2012-06-26 |
| 1316203755 | Hisami Sarah Hayashi | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2012-04-10 |
| 1215220363 | Glenn Stephen Coats | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2011-05-24 |
| 1518286517 | Adam Kyle Haste | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2010-05-31 |
| 1518131077 | Andrew Joseph Norton | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2008-04-16 |
| 1487840872 | Edward Kwang Yi | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2007-09-19 |
| 1225222367 | Erik Jan Bekkers | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2007-08-31 |
| 1720271471 | Indu Rekha Meesa | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2007-08-24 |
| 1699970566 | Daniel George Branam | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2007-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710464938 | Heather Smith | Day Training/Habilitation Specialist | 9434 Lima Road, Suite C, Fort Wayne, IN 46818 | 2018-07-20 |
| 1184146748 | Danielle Macias | Speech-Language Pathologist | 4935 Hillegas Road, Suite 200, Fort Wayne, IN 46818 | 2017-07-14 |
| 1801326533 | Kimberly M Kindt | Optometrist | 9426 Lima Rd Ste C, Fort Wayne, IN 46818 | 2017-06-15 |
| 1578983359 | Sarah Buzzard | Occupational Therapy Assistant | 9426 Lima Road, A, Fort Wayne, IN 46818 | 2014-04-21 |
| 1306196704 | Peter Yang Gaw Go | Occupational Therapist | 3406 Bluefield Place, Fort Wayne, IN 46818 | 2012-09-12 |
| 1043593536 | Carol Lynn Steinbach | Massage Therapist | 12101 Hand Rd., Fort Wayne, IN 46818 | 2011-09-21 |
| 1295058071 | Summit Nutrition Services, LLC | Dietitian, Registered | 3027 Mariposa Place, Fort Wayne, IN 46818 | 2010-03-08 |
| 1184871899 | The Arc of Northeast Indiana, Inc | Intermediate Care Facility, Mentally Retarded | 9104 Strathmore Lane, Fort Wayne, IN 46818 | 2008-08-25 |
| 1285851121 | Angela Coleman | Dentist | 10505 Lima Road, Fort Wayne, IN 46818 | 2007-04-20 |
| 1942335534 | Angela S King | Dentist | 9019 Lima Road, Fort Wayne, IN 46818 | 2007-02-22 |
| Find all providers in zip 46818 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376789420 | Richard Frederick Fox | Radiology | 6226 Devils Hollow Rd., Fort Wayne, IN 46814 | 2008-12-19 |
| 1578607149 | Garland Richard Brown | Radiology | 1007 Three Rivers N, Fort Wayne, IN 46802-1334 | 2007-02-16 |
| 1932205077 | Kavita K Erickson | Radiology | 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 | 2006-09-16 |
| 1033226154 | Alan S. Cooperman | Radiology | 14110 Spring Hollow Rd, Fort Wayne, IN 46814-9767 | 2006-08-24 |
| 1336174598 | Mitchell E F Travis | Radiology | 10517 Maple Springs Cv, Fort Wayne, IN 46845-2132 | 2006-07-12 |
| 1023062130 | Gregg R Mattison | Radiology | 3707 New Vision Drive, Fort Wayne, IN 46895-5602 | 2006-05-22 |
| 1184678278 | Charles Tsai | Radiology | 109 Chestnut Hills Pkwy, Fort Wayne, IN 46814-8924 | 2006-05-22 |
| 1922061613 | Mri Center - Fort Wayne Radiology Inc | Radiology | 2110 Carew St, Fort Wayne, IN 46805-4712 | 2006-04-11 |
| 1861455669 | Open View Mri, LLC | Radiology | 10202 Coldwater Rd, Fort Wayne, IN 46825-2076 | 2006-04-11 |
| 1902870033 | Jay T Jones | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2006-02-15 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46818 |
Please comment or provide details below to improve the information on DR. RANDALL JOSEPH PHILLIPS.
| 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.