Individual provider Active NPI

Sebrina Phillips, RN, NP-C

  • Nurse Practitioner
  • Jefferson, NC
National Provider Identifier
1194228833
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010714 Issued in NC
Practice address
200 Hospital Ave Ste 5
Jefferson, NC 28640
Phone
(336) 846-7779
Fax
(336) 846-8370
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 139154 NC
Nurse Practitioner 363L00000X 5010714 NC Primary

Addresses

Primary practice location

200 Hospital Ave Ste 5
Jefferson, NC 28640

Mailing address

280 Fannie Cove Ext
Warrensville, NC 28693-9293

Other practice location 1

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (336) 846-7101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190228000606 NC Practitioner - Nurse Practitioner 8426397944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charles W Jones MD PAGroup PAC ID 8426159096, 2 clinicians

Practice addresses (Care Compare)

200 Hospital Ave
Suite 5
Jefferson, NC 28640-9244
Phone (336) 246-7779

Hospital & facility affiliations

  • Ashe Memorial Hospital Hospital, Jefferson, NC, CCN 341325

Merit-based Incentive Payment System (MIPS)

Final score
80.17 of 100Reported as group
Quality
67.28
Improvement activities
40
Cost
77.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139154NCMDRegistered Nurse
5010714NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles W Jones MD PA CurrentSince Sep 4, 2018 Accepting new patients

Locations

200 Hospital Ave
Ste 5
Jefferson, NC 28640
Phone (336) 246-7779

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

Interoperability endpoints

  • Direct secure messaging: sebrinaphillips@drcwjones.ssdirect.aprima.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1194228833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 FANNIE COVE EXT",
            "city": "WARRENSVILLE",
            "state": "NC",
            "postal_code": "286939293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE STE 5",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "28640",
            "telephone_number": "336-846-7779",
            "fax_number": "336-846-8370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "NC",
            "postal_code": "286409244",
            "country_code": "US",
            "telephone_number": "336-846-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SEBRINA",
        "credential": "RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "139154",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

Verify at the official NPI Registry.