Provider Demographics
NPI:1013456888
Name:PHIPPS, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 ESTATE SION FARM
Mailing Address - Street 2:SUITE 25
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820
Mailing Address - Country:US
Mailing Address - Phone:340-692-1116
Mailing Address - Fax:
Practice Address - Street 1:4200 ESTATE SION FARM
Practice Address - Street 2:SUITE 25
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-692-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic