Individual provider Active NPI

Elizabeth Yolanda Phillips, FNP

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1114576592
Registry record updated Sep 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26350 Issued in TN
Practice address
7645 Wolf River Cir
Germantown, TN 38138-1751
Phone
(901) 869-2929
Fax
(901) 922-6845
NPI assigned
Sep 8, 2019
Last updated
Sep 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903418 MS
Family Nurse Practitioner 363LF0000X 26350 TN Primary

Addresses

Primary practice location

7645 Wolf River Cir
Germantown, TN 38138-1751

Mailing address

6177 Seminole Dr
Olive Branch, MS 38654-3123
Phone (901) 487-7944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210503000179 TN Practitioner - Nurse Practitioner 3173932209 Reassigns benefits to 1 organization
I20210806002072 MS Practitioner - Nurse Practitioner 3173932209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memphis Neurology PLLCGroup PAC ID 2264510718, 6 clinicians

Practice addresses (Care Compare)

7645 Wolf River Cir
Suite 100
Germantown, TN 38138-1751
Phone (901) 405-0275

7684 Airways Blvd
Southaven, MS 38671-5304
Phone (901) 405-0275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15658TNMDAnesthesiology Physician
903418MSMDFamily Nurse Practitioner
26350TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mittal Kidney and Dialysis PC PastSince Aug 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ephillips25932@mlh.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFDAA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567900800000",
    "number": "1114576592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 SEMINOLE DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543123",
            "telephone_number": "901-487-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-869-2929",
            "fax_number": "901-922-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ELIZABETH",
        "middle_name": "YOLANDA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2019-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903418",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.