ANNA MARY AMES PHILLIPS – Clinical Social Worker, NPI 1336974211

ANNA MARY AMES PHILLIPS is a healthcare provider. based in Lauderdale, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 27944 (MN). The NPI Number for ANNA MARY AMES PHILLIPS is 1336974211

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
ANNA MARY AMES PHILLIPS
NPI
1336974211
Phone
(612) 280-9168
Address
1779 WALNUT ST
Enumeration Date
3 September 2024
Last Update Date
3 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6513306205
Graduation Year
2021 (5 years ago)
PAC ID
6305370826
Group Practice PAC ID
4688002579
Professional Enrollment ID
I20241106003137
Address ID
MN551133181RO2565XNXXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for ANNA MARY AMES PHILLIPS

  • 1779 WALNUT ST

    LAUDERDALE, MN 551135243

    Phone: (612) 280-9168

    Fax: (651) 330-8718

    Type: Mailing

  • 2565 HAMLINE AVE N STE A

    ROSEVILLE, MN 551133181

    Phone: (763) 515-8893

    Fax: (651) 330-8718

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241106003137IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55113)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688002579View full group profile
NameSpecialtyState
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorWI
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

What number should I use to identify ANNA MARY AMES PHILLIPS for billing?
Administrative and clinical systems typically use NPI 1336974211 for ANNA MARY AMES PHILLIPS.
Quick check: is ANNA MARY AMES PHILLIPS active?
Public NPPES data shows ANNA MARY AMES PHILLIPS with an active NPI status right now.
Which specialty label fits ANNA MARY AMES PHILLIPS?
NPPES ties ANNA MARY AMES PHILLIPS to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ANNA MARY AMES PHILLIPS?
ANNA MARY AMES PHILLIPS is associated with Lauderdale, Minnesota in the same public data insurers reference.
Who maintains ANNA MARY AMES PHILLIPS's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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