Krystal Inman Phillips, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Martinsville, VA
NPI 1104441997 · NPPES record last updated Jun 8, 2020
Key facts
- NPI
- 1104441997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024179235 (VA)
- Practice address
- 15 Cleveland Ave Ste 14
Martinsville, VA 24112-2937 - Phone
- (276) 632-9714
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201113000896 | VA | Practitioner - Nurse Practitioner | 7517377955 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Atlantic Quickcare PLLC | Current |
Accepting new patients |
Locations
5261 Carrollton Pike
Ste C
Woodlawn, VA 24381
Phone (276) 238-0911
Interoperability endpoints
- https://api.platform.athenahealth.com/21964/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024179235 | VA | Yes |
Addresses
Primary practice location
15 Cleveland Ave Ste 14
Martinsville, VA 24112-2937
Mailing address
15 Cleveland Ave Ste 14
Martinsville, VA 24112-2937
Phone (276) 632-9714
Other providers in Martinsville, VA
- PHC - Martinsville Inc
- PHC - Martinsville Inc
- PHC-Martinsville Inc
- PHC-Martinsville, Inc.
- Jennifer Walker Phelps
- Phoenix Home Care of Virginia
- Physician Management Services of Virginia II, LLC
- Piedmont Access to Health Services, Inc
- Piedmont Access to Health Services, Inc
- Piedmont Dermatology Center, PC
All providers in Martinsville, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.