Individual provider Active NPI

Carrie M Phillips, PA-C

  • Physician Assistant
  • Gainesville, GA
National Provider Identifier
1104075415
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1787 Issued in GA
Practice address
700 S Enota Dr NE
Gainesville, GA 30501-2403
Phone
(770) 531-3711
Fax
(770) 531-3718
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeastern Rheumatology Alliance 24 clinicians

Practice addresses (Care Compare)

1715 Resurgence Dr
Suite 201
Watkinsville, GA 30677-7306
Phone (706) 410-9270

700 S Enota Dr NE
Gainesville, GA 30501-2403
Phone (770) 531-3711

Hospital & facility affiliations

  • Union General Hospital Hospital, Blairsville, GA, CCN 110051

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20081014000025 GA Practitioner - Physician Assistant 9830267145 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1787GAMDPhysical Therapist
001787GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
NGDC Sleep Med Lab Past Accepting new patients
Southeastern Rheumatology Alliance Past Accepting new patients
Brent a Flickinger MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carrie.phillips.p1@direct.acng.nextgenshare.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1787 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

700 S Enota Dr NE
Gainesville, GA 30501-2403

Mailing address

700 S Enota Dr NE
Gainesville, GA 30501-2403
Phone (770) 531-3711

Other practice location 1

1715 Resurgence Dr Ste 201
Watkinsville, GA 30677-7321
Phone (706) 410-9270

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 14, 2025.

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1104075415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012403",
            "telephone_number": "770-531-3711",
            "fax_number": "770-531-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012403",
            "telephone_number": "770-531-3711",
            "fax_number": "770-531-3718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1715 Resurgence Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777321",
            "country_code": "US",
            "telephone_number": "706-410-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CARRIE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.