HOLLY ANN PHILLIPS, CLC — NPI 1053034108 (Licensed & Credentialed Lactation Consultant, Non-RN in SPRINGFIELD, MO)

CMS-1500 Box 24J / 33a • NPI

1053034108

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

174N00000X

Licensed & Credentialed Lactation Consultant, Non-RN

Box 32 Service Location & ZIP+4

1901 S VENTURA AVE STE B, SPRINGFIELD, MO, 65804-2700

✓ 9-Digit EDI 837 ZIP+4 (65804-2700)

Practice Phone & Referral Fax

(417) 233-1100

Fax: (417) 622-4454

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1053034108 (HOLLY ANN PHILLIPS, CLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1053034108` (NPI-1 Individual Practitioner)
Provider / Legal Name	HOLLY ANN PHILLIPS, CLC
Plain-English Specialty	Licensed & Credentialed Lactation Consultant, Non-RN NUCC Code: `174N00000X` (Lactation Consultant, Non-RN)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1901 S VENTURA AVE STE B, SPRINGFIELD, MO, 65804-2700
Practice Telephone / Fax	Tel: (417) 233-1100 \| Fax: (417) 622-4454
Administrative Mailing Address	1901 S VENTURA AVE STE B, SPRINGFIELD, MO, 65804-2700
Enumeration & Last Sync	Enumerated: 2022-09-23 \| CMS Record Updated: 2022-09-23

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1901 S VENTURA AVE STE B, SPRINGFIELD, MO, 65804-2700

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Plain-English Taxonomy & CMS Crosswalk (174N00000X)

What Does Taxonomy Code 174N00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 174N00000X translates to:
"Licensed & Credentialed Lactation Consultant, Non-RN"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Lactation Consultant, Non-RN for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (HOLLY ANN PHILLIPS, CLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`174N00000X` — Lactation Consultant, Non-RN Plain English: Licensed & Credentialed Lactation Consultant, Non-RN	State: MO \| License: `329048` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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HOLLY ANN PHILLIPS, CLC (NPI #1053034108)