Kimberly Dawn Phillips, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-074781 Issued in AL

Practice address

1812 E Main St
Dothan, AL 36301-3000

Phone

(334) 792-5184

NPI assigned

Jun 11, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CH MSSP Services Al LLCGroup PAC ID 4688039142, 13 clinicians

Remedy Behavioral Health LLCGroup PAC ID 3375958853, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Remedy Behavioral Health, LLC

  dba Remedy Behavioral Health

  • Psychiatry Physician
  • Florence, AL
  • NPI 1013517317

  Family

  Medicare reassignment Care Compare group NPD
• CH MSSP Services Al LLC

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1063111979
  Medicare reassignment Care Compare group
• Enterprise Clinic LLC

  • Family Medicine Physician
  • Enterprise, AL
  • NPI 1639491616
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba SAMC- Profee Billing

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134
  NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Medcore Associates, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1992524607
  NPD
• Pathology Laboratory Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1134190648
  NPD
• Shoals NP Homecare, LLC

  • Home Health Agency
  • Town Creek, AL
  • NPI 1083178818
  NPD

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1205249869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013000",
            "telephone_number": "334-792-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013000",
            "telephone_number": "334-792-5184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Ross Clark Cir",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363013022",
            "country_code": "US",
            "telephone_number": "334-793-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-074781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Phillips, P.T.
• Debra Elaine Phillips, NP
• Ellen D Phillips, M.D.
• Hunter B Phillips, DC
• Joseph Jason Phillips, M.D.
• Leigh Phillips
• Sara Frances Phillips, RN, BSN
• Victoria Rose Phillips, DO
• Physician Management Services of Alabama LLC
• Frederick Albert Pich III, D.O.

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.