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Deactivated NPI 1104278993 Deactivated / Inactive NPI Female Practitioner

Misty Phillips , FNP

Nurse Practitioner • Baldwin, WI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Misty Phillips has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 06, 2016
NPI Deactivation Date August 04, 2017
Total Practice Duration ~1 Years of Practice (2016 – 2017)

Professional Overview & Biography Verified Profile Summary

Misty Phillips, FNP was a registered Nurse Practitioner practicing in Baldwin, WI. Throughout an active medical career spanning 1 years, Misty Phillips provided care at the practice location at 1100 BERGSLIEN STREET until profile deactivation on 2017-08-04.

Practice Location & Contact Primary Location

Practice Address

1100 Bergslien Street

Baldwin, WI 540022600

Telephone 7156841111
Fax 7156841119
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Baldwin, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 4.6 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
8 Specialists

Practicing in Baldwin, WI (4030 Statewide)

Telehealth Adoption Rate
12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License WI 7023-33

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Sarah Anderson , NP

Nurse Practitioner - Family

NPI 1003242306

Nurse Practitioner

Dr. Eyuel Terefe , MD

Psychiatry & Neurology - Psychiatry

NPI 1003341652

Doctor of Medicine (M.D.)

Abbey Arndt , NP

Nurse Practitioner - Family

NPI 1003508136

Nurse Practitioner

Dr. Elizabeth Rau , DPT

Physical Therapist

NPI 1053027847

Doctor of Physical Therapy

Christine Veenendall

Registered Nurse

NPI 1053861682
Alicia Sund

Nurse Practitioner

NPI 1114763786

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 04, 2017

Record deactivated on August 04, 2017

NPI Profile Active July 06, 2016

NPI status registered as active in NPPES database

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Updated Practice Location July 06, 2016

Registered at 1100 BERGSLIEN STREET, BALDWIN, WI 540022600 (Tel: 7156841111)

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Updated Business Mailing Address July 06, 2016

Registered at 1100 BERGSLIEN STREET, BALDWIN, WI 540022600 (Tel: 7156841111)

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Provider Name / Credentials Updated July 06, 2016

Recorded as MISTY PHILLIPS, FNP

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 06, 2016

Nurse Practitioner (License #7023-33 in WI)

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Initial NPI Registration & Enumeration July 06, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104278993
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2016
Last Update: July 06, 2016
Deactivation Date: August 04, 2017

Mailing Address

1100 Bergslien Street

Baldwin, WI 540022600

Phone: 7156841111

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.