MEDICARE: DR. ERVIN L PHIPPS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	36244	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4635513	OTHER	NC	AETNA ID
2	D4352	OTHER	NC	MEDCOST ID
3	1445798	OTHER	NC	UNITED HEALTHCARE ID
4	3368838	OTHER	NC	CIGNA ID
5	67447	OTHER	NC	BLUE CROSS BLUE SHIELD
6	1105239	OTHER	NC	FIRST HEALTH ID
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235130477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERVIN L PHIPPS MD

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 NASHVILLE COMMONS DR
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1823
Country	:	US
Telephone Number	:	252-453-7769
Fax Number	:	252-459-6539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	08/09/2021

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