MR. WILLIE PHILLIPS II (NPI# 1154813756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154813756 |
| Entity Type | Individual |
| Full Name | MR. WILLIE PHILLIPS II |
| Credential | ATC |
| Practice Address |
1900 Selwyn Ave Charlotte NC 28274-0001 |
| Practice Telephone | 7043372405 |
| Mailing Telephone | 7043372405 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
LAT-3766 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NATABOC | 2000008378 | 01 |
| NC | NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS | LAT-3766 | 01 |
| Street Address |
1900 SELWYN AVE |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28274-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942404124 | Varvara Pasiali | Music Therapist | 1900 Selwyn Ave, Charlotte, NC 28274-1120 | 2007-06-12 |
| 1457986515 | Queens University of Charlotte | Family Medicine | 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2020-03-10 |
| 1962994574 | Rachel Lea Taylor | Specialist/Technologist | 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2018-05-31 |
| 1174015788 | Jordan Heinlein | Specialist/Technologist | 1900 Selwyn Ave, Charlotte, NC 28207-2450 | 2018-05-31 |
| 1003297367 | Meg Johnson | Music Therapist | 1900 Selwyn Ave, Queens University of Charlotte, Charlotte, NC 28274-0001 | 2015-06-12 |
| 1518389808 | Michael Haber | Community Health Worker | 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2014-01-06 |
| 1205189008 | Healthstat- Queens University | Preventive Medicine | 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2012-10-18 |
| 1013195031 | Rebecca Hope Rich | Specialist/Technologist | 1900 Selwyn Ave, #421, Charlotte, NC 28274-0001 | 2008-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376035972 | Nashea Kiehl | Specialist/Technologist | Queens University of Charlotte 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2018-05-31 |
| 1356583496 | Sandra Lynn Rogelberg | Counselor | Queens University of Charlotte, 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2009-04-06 |
| 1154522019 | Sue M. Setzer | Specialist | Union Theological Seminary-psce At Charlotte, 1900 Selwyn Avenue, Charlotte, NC 28274-0001 | 2007-05-29 |
| 1962037127 | A Square Transportation Services Incorporated | Transportation Broker | 13634 Royalwood Ln, Charlotte, NC 28274-4716 | 2020-03-09 |
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437665361 | Novant Medical Group, Inc. | Physical Medicine & Rehabilitation | 8035 Providence Rd Ste 100, Charlotte, NC 28277-9716 | 2017-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679130744 | Mojo Sportclinic, LLC | Physical Medicine & Rehabilitation | 6859 Monument Dr, Wilmington, NC 28405-4178 | 2019-05-23 |
| 1679138176 | Jeneva Gatses | Physical Medicine & Rehabilitation | 13759 Cinnabar Pl, Huntersville, NC 28078-5342 | 2019-05-09 |
| 1285159905 | Austin John Hille | Physical Medicine & Rehabilitation | 400 Landis Ct. #203, Asheville, NC 28806 | 2017-08-03 |
| 1174052138 | Olivia Sabo | Physical Medicine & Rehabilitation | 8814 Red Rd, Rockwell, NC 28138-6500 | 2017-06-05 |
| 1770180903 | Kenneth Lassiter | Physical Medicine & Rehabilitation | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2020-10-01 |
| 1588296719 | Douglas Maccallum | Physical Medicine & Rehabilitation | 2121 E Williams St Ste 108, Apex, NC 27539-7765 | 2020-02-05 |
| 1972153419 | Meredith Elise Bland | Physical Medicine & Rehabilitation | 3475 Erwin Rd, Durham, NC 27705-0005 | 2019-09-17 |
| 1275188484 | Edward Albert Marshall Jr. | Physical Medicine & Rehabilitation | 224 East Wilson Street, Wingate, NC 28174 | 2019-08-05 |
| 1881174878 | Jaela Marie Wilson | Physical Medicine & Rehabilitation | 1801 Fayetteville St, Durham, NC 27707-3129 | 2018-08-19 |
| 1841784170 | Jordan Drew Bettleyon | Physical Medicine & Rehabilitation | 5400 Ramsey St, Fayetteville, NC 28311 | 2018-06-20 |
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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.