JACQUELINE PHILLIPS DPM INC (NPI# 1821027756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821027756 |
| Entity Type | Organization |
| Organization Name | JACQUELINE PHILLIPS DPM INC |
| Practice Address |
5575 Conner St Suite 203 Detroit MI 48213-6400 |
| Practice Telephone | 3133454449 |
| Mailing Telephone | 3133454449 |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2011-12-09 |
| Authorized Official Name | DR. JACQUELINE PHILLIPS (PODIATRIST) |
| Authorized Official Telephone | 3133454449 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 5901001422 | MI | Suppliers |
| Y | 213E00000X | Podiatrist | 5901001422 | MI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 134313228 | 05 | |
| MI | BCBS PIN | 480H232340 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750657821 | Jacqueline Phillips Dpm Inc | Durable Medical Equipment & Medical Supplies | 5575 Conner St, Suite 203, Detroit, MI 48213-6400 | 2012-03-22 |
| Street Address |
5575 CONNER ST SUITE 203 |
| City | DETROIT |
| State | MI |
| Zip Code | 48213-6400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689293458 | World Wide Clinical Labz LLC | Clinical Medical Laboratory | 5575 Conner St, Detroit, MI 48213-6400 | 2020-04-13 |
| 1295361004 | Angela Colette Walker-tolbert | Counselor | 5575 Conner St, Detroit, MI 48213-6400 | 2020-03-13 |
| 1124532296 | Willie Campbell Jr. | Psychologist | 5575 Conner St, Detroit, MI 48213-6400 | 2017-11-27 |
| 1881053874 | Theyazan Kohaif | Social Worker | 5575 Conner St, Detroit, MI 48213-6400 | 2016-02-18 |
| 1295123180 | Phillips Foot Clinic | Podiatrist | 5575 Conner St, Suite 203, Detroit, MI 48213-6400 | 2014-12-31 |
| 1578976437 | Seton Health Corporation of Southeastern Michigan | Clinic/Center | 5575 Conner St, Detroit, MI 48213-6400 | 2014-06-09 |
| 1386060127 | John Evans | Counselor | 5575 Conner St, Suite 201 Pavilion Building, Detroit, MI 48213-6400 | 2014-03-17 |
| 1720424013 | Samaritan Urgent Care PC | Clinic/Center | 5575 Conner St, Detroit, MI 48213-6400 | 2013-05-14 |
| 1912343203 | Samaritan Urgent Care PC | Internal Medicine | 5575 Conner St, Detroit, MI 48213-6400 | 2013-05-14 |
| 1750657821 | Jacqueline Phillips Dpm Inc | Durable Medical Equipment & Medical Supplies | 5575 Conner St, Suite 203, Detroit, MI 48213-6400 | 2012-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540430 | Sheronda Lanetta Blackmon | Licensed Practical Nurse | 13929 Harper Ave., Detroit, MI 48213 | 2020-08-27 |
| 1073049144 | Cheryl Williams | Community Health Worker | 13929 Chalmers Ave., Detroit, MI 48213 | 2017-05-10 |
| 1164963401 | Smile Fresh Detroit PC | Dentist | 7230 Gratiot Avenue, Detroit, MI 48213 | 2017-03-20 |
| 1255887899 | Jay Washington | Behavioral Analyst | 9146 Haper, Detroit, MI 48213 | 2016-09-01 |
| 1396129532 | Sarietha King | Home Health | 14639 Manistique, Detroit, MI 48213 | 2015-07-17 |
| 1366823197 | Royal Treatment Mental Health Systems, LLC | Counselor | 5555 Corner Avenue, Detroit, MI 48213 | 2015-06-17 |
| 1477956779 | Monique Powell | Student in an Organized Health Care Education/Training Program | 5801 Lakeview S.t, Detroit, MI 48213 | 2014-09-30 |
| 1629339163 | Samuel Joseph Farmer | Counselor | 10100 Harper Ave., Detroit, MI 48213 | 2012-05-31 |
| 1609164755 | Vernon Keith Johnson | Social Worker | 20203 Kelly Road, Detroit, MI 48213 | 2011-07-11 |
| 1023312790 | Davenport Quality Home Care LLC | Home Health | 5027 Maxwell, Detroit, MI 48213 | 2011-01-10 |
| Find all providers in zip 48213 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124422233 | Arnold S. Gross, Dpm PC | Podiatrist | 18254 Livernois Ave Ste 2, Detroit, MI 48221-4214 | 2014-10-17 |
| 1366629594 | Lawrence B Rubin Dpm PC | Podiatrist | 18530 Grand River, Detroit, MI 48223 | 2008-01-30 |
| 1912116807 | 7-huntington Podiatry Associates PC | Podiatrist | 19350 West Seven Mile Rd, Detroit, MI 48219 | 2007-05-21 |
| 1447471669 | Wendy W. Webster Dpm,pc | Podiatrist | 19933 Livernois Ave, Ste B, Detroit, MI 48221-1234 | 2007-05-02 |
| 1538200019 | James Schelberg | Podiatrist | 500 Griswold St, Ste 1b, Detroit, MI 48226-3480 | 2007-02-09 |
| 1578651253 | Ralph J Zicherman | Podiatrist | 18663 Livernois Avenue, Detroit, MI 48221 | 2006-10-10 |
| 1245327543 | Charles Marvin Johnson | Podiatrist | 10244 W 7 Mile Rd, Detroit, MI 48221-1904 | 2006-10-06 |
| 1326153537 | Ronald A Hackelman | Podiatrist | 634 Chene Street, Detroit, MI 48207 | 2006-08-20 |
| 1336252857 | Podiatry Examiners of Michigan PC | Podiatrist | 3800 Woodward Avenue, Suite 318, Detroit, MI 48201-2066 | 2006-08-17 |
| 1992734727 | Sylvia L Loving | Podiatrist | 18300 W Mcnichols Rd, Detroit, MI 48219-4162 | 2006-07-02 |
| Find all providers in DETROIT | ||||
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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.