Individual provider Active NPI

Taylor Nikole Phillips, PA-C

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1114885688
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
410 Pelham St
Fredericksburg, VA 22401-3539
Phone
(571) 408-3308
NPI assigned
Jan 13, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

410 Pelham St
Fredericksburg, VA 22401-3539

Mailing address

410 Pelham St
Fredericksburg, VA 22401-3539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20260330000468 DC Practitioner - Physician Assistant 3971088873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1114885688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PELHAM ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PELHAM ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013539",
            "telephone_number": "571-408-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TAYLOR",
        "middle_name": "NIKOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.