Dr Faith Lucille Phillips, PHD is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Broken Bow, Oklahoma. Her current practice location is
411 S. Park Drive, Broken Bow, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 584-5550.
Dr Faith Lucille Phillips is licensed to practice in Oklahoma (license number 513) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699925867.
Healthcare Provider's Profile
| Full Name | Dr Faith Lucille Phillips |
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| Gender | Female |
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| Speciality | Psychologist - Clinical Child & Adolescent |
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| Location | 411 S. Park Drive, Broken Bow, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699925867
- Provider Enumeration Date: 09/24/2008
- Last Update Date: 07/25/2018
Medicare PECOS Information:
- PECOS PAC ID: 1456692508
- Enrollment ID: I20190418000408
Medical Identifiers
Medical identifiers for Dr Faith Lucille Phillips such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699925867 | NPI | - | NPPES |
| 100837660A | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 513 (Oklahoma) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 513 (Oklahoma) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Faith Lucille Phillips allows following entities to bill medicare on her behalf.
| Entity Name | Faith L Phillips Phd Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104079474
PECOS PAC ID: 2466793518
Enrollment ID: O20190418000319 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Faith Lucille Phillips is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Faith Lucille Phillips, PHD
411 S. Park Drive,
Broken Bow, OK 74728-3331
Ph: (580) 584-5550 | Dr Faith Lucille Phillips, PHD
411 S. Park Drive,
Broken Bow, OK 74728
Ph: (580) 584-5550 |
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