Provider Demographics
NPI:1457394868
Name:PHILLIPS, SCOTT ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ASHLEY
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7915
Mailing Address - Country:US
Mailing Address - Phone:864-512-6927
Mailing Address - Fax:864-512-6687
Practice Address - Street 1:100 HEALTHY WAY
Practice Address - Street 2:SUITE 1250
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-7915
Practice Address - Country:US
Practice Address - Phone:864-512-6927
Practice Address - Fax:864-512-6687
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33068207RC0000X, 207RI0011X
TN38964208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00986304OtherRR MEDICARE
TN33278871Medicaid
TN3327886Medicaid
TN3327887Medicaid
TN4152415OtherBLUECROSS
TN4108302OtherBLUECROSS
TNP00384340OtherRAILROAD MEDICARE
TN3327887Medicare PIN
SCP00986304OtherRR MEDICARE
I29157Medicare UPIN
TN3327886Medicaid
TN4152415OtherBLUECROSS