Phyllis Eason

Psychiatry Poplar Bluff Regional Medical Center NPI1174596746

Summary

About

Phyllis Eason specialises in Psychiatry. She currently works at Poplar Bluff Regional Medical Center in North Dakota.

Provider Details

NPI Number 1174596746
Provider Name Phyllis Eason
Credential MD
Specialization Psychiatry
Medical School Name University Of Arkansas College Of Medicine
Graduation Year 1990
Gender F
Entity Type Individual
PAC ID by PECOS 1355307075
Professional Enrollment ID I20160210001933
Enumeration Date 02/13/2006
Last Update Date 11/04/2013

Contact Details

Business Practice address 100 4TH ST S, Fargo,
58103-1929 North Dakota View on Google Map
Business Practice phone 701-234-3100
Business Practice fax 701-234-3120
Mailing address PO BOX 2168, Fargo,
58107-2168 North Dakota View on Google Map
Other phone 701-234-2119
Other fax
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Phyllis Eason MD Update NPI

Payments

Total Payment Worth

$466.05
from 30 payments in the last 6 years

Total Cash or Cash Equivalent

$0.00
from 0 payments in the last 6 years

Total In-kind Items & Services

$466.05
from 30 payments in the last 6 years

Hospital Affilitation

Poplar Bluff Regional Medical Center in Fargo

Fargo, North Dakota

Education & Training

University Of Arkansas College Of Medicine

Psychiatry, 1990

Group Affiliation

Organization Name PECOS PAC ID Members
Mosaic Medical Center - Maryville 3678813896 77
Poplar Bluff Hma Physician Management, Llc 5092769703 41

Public Reporting for Performance Scores

More Details

Final MIPS Score

97.99 out of 100

Score Breakdown

Quality Category Score 92.21
PI Category Score 93.9

 

IA Category Score 40
Cost Category Score 0
Total Patients: 11
Source of Scores: apm, group
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Provider Taxonomy 1
Taxonomy
License No.
043926 (Georgia)
Primary Taxonomy
Taxonomy
License No.
PT12912 (North Dakota)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1174596746
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Eason
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Phyllis
The first name of the provider, if the provider is an individual.
Provider Credential Text M.D.
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address PO BOX 2168
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Fargo
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name North Dakota
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 58107-2168
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 701-234-2119
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider First Line Business Practice Location Address 100 4TH ST S
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Fargo
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name North Dakota
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 58103-1929
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 701-234-3100
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 701-234-3120
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 02/13/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 11/04/2013
The date that a record was last updated or changed.
Provider Gender Code F
The code designating the provider's gender if the provider is a person.
Provider Gender Female
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 2084P0800X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Healthcare Provider Taxonomy #1
Provider License Number 1 043926
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 GA
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #2 2084P0800X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 2 A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Healthcare Provider Taxonomy #2
Provider License Number 2 PT12912
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2 ND
Provider License Number State Code #2
Healthcare Provider Primary Taxonomy Switch 2 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.