Katherine Anne Phillips, APRN-FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209017309 Issued in IL

Practice address

1102 N County Road 700
Warsaw, IL 62379-3011

Phone

(217) 256-4100

Fax

(217) 256-3800

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital AssociationGroup PAC ID 0244134682, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Hospital Association

  • Critical Access Hospital
  • Carthage, IL
  • NPI 1730139031

  IL

  Medicare reassignment Care Compare group
• Phillips Mental Health Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Keokuk, IA
  • NPI 1316773757
  NPD Authorized official
• Memorial Hospital Association

  • Critical Access Hospital
  • Carthage, IL
  • NPI 1073858262
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • La Harpe, IL
  • NPI 1184027849
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Carthage, IL
  • NPI 1205887742
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Bowen, IL
  • NPI 1437100831
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Carthage, IL
  • NPI 1588614002
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Hamilton, IL
  • NPI 1679327779
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Colchester, IL
  • NPI 1699228882
  Care Compare group
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Nauvoo, IL
  • NPI 1891972451
  Care Compare group
• Counseling Associates, Inc

  • Community/Behavioral Health Agency
  • Keokuk, IA
  • NPI 1598922643
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1013410158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 N COUNTY ROAD 700",
            "city": "WARSAW",
            "state": "IL",
            "postal_code": "623793011",
            "telephone_number": "217-256-4100",
            "fax_number": "217-256-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 N COUNTY ROAD 700",
            "city": "WARSAW",
            "state": "IL",
            "postal_code": "623793011",
            "telephone_number": "217-256-4100",
            "fax_number": "217-256-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "APRN-FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Grotts
• Teresa Metzger, N.P.
• Eliot M Nissenbaum, DO
• Richard Lewis O'Halloran, M.D.
• Annette Yvonne Oetken, D.O.
• River'S Edge Wellness PLLC
• Warsaw Comm Unit SCHL Dist 316
• Darlene Louise Young
• Dale D Zimmerman, D.O.

• All providers in Warsaw, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.