Individual provider Active NPI

Deborah K Phillips, MD

  • Dermatology Physician
  • Lexington, KY
National Provider Identifier
1124002811
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
39747 Issued in KY
Practice address
4071 Tates Creek Centre Dr Ste 202
Lexington, KY 40517-3094
Phone
(859) 226-0206
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 39747 KY Primary

Addresses

Primary practice location

4071 Tates Creek Centre Dr Ste 202
Lexington, KY 40517-3094

Mailing address

4071 Tates Creek Centre Dr Ste 202
Lexington, KY 40517-3094
Phone (859) 226-0206

Other identifiers 2

IdentifierTypeStateIssuer
000000745869OtherKYANTHEM
4492275OtherKYAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101011000199 KY Practitioner - Dermatology 0547219495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.2 of 100Reported as group
Quality
93.98
Promoting interoperability
100
Improvement activities
40
Cost
76.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Skin Cancer Specialists, PSC CurrentSince Feb 23, 2024 Accepting new patients
Wallis Dermatology Associates PLLC Dermatology Past Accepting new patients
Deborah K Phillips Mdpa PastSince Aug 1, 1993 Accepting new patients

Locations

161 N Eagle Creek Dr
Ste 150
Lexington, KY 40509
Phone (270) 852-1645

Organizations & group practices 3

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1124002811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173094",
            "telephone_number": "859-226-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173094",
            "telephone_number": "859-226-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "39747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000745869",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4492275",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.