Kelley J Phillips, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

M1293 Issued in TX

Practice address

3500 Gaston Ave
Dallas, TX 75246-2096

Phone

(214) 820-2505

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelley.phillips.1@13131.direct.athenahealth.com

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.

• Innovative Emergency Physicians of Frisco, PA

  • Emergency Medicine Physician
  • Frisco, TX
  • NPI 1871832188
  Medicare reassignment NPD
• Pediatric Emergency Medicine Group LLP

  • Emergency Medicine Physician
  • Plano, TX
  • NPI 1629448535
  Medicare reassignment NPD
• Questcare Medical Services, PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1912059247
  Medicare reassignment NPD
• Ray Hubbard Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Sunnyvale, TX
  • NPI 1629145362
  Medicare reassignment NPD
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• Questcare Medical Services, PLLC

  • Nurse Practitioner
  • Arlington, TX
  • NPI 1497807713

  Emergency Medicine

  NPD
• Ray Hubbard Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Sunnyvale, TX
  • NPI 1073905568
  NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1205880036
  NPD
• C3Erow, LLC

  • Emergency Care Clinic/Center
  • Rockport, TX
  • NPI 1548700990
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1174579403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 VERDE LANE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75034",
            "telephone_number": "469-287-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462096",
            "telephone_number": "214-820-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KELLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M1293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176422707",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176422708",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H4406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey H Phillips, M.D.
• Jenna Phillips, DDS
• Jonathan Blackmore Phillips, CRNA
• Joseph Theodore Phillips Jr., M.D.
• Kambrie Phillips, M.S. CF-SLP
• Kimberly Lavender Phillips, LMSW
• Lauren Therese Phillips, MD
• Leah Phillips, PHD
• Marisa Phillips
• Morgan Phillips, CNP

• Emergency Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.