Jacob William Phillips, D.O.

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

H0089766 Issued in MD

Practice address

1801 McCormick Dr Ste 180
Largo, MD 20774-5345

Phone

(301) 883-0866

NPI assigned

Apr 21, 2015

Sex

Male

Sole proprietor

No

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 NC

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

Specialty

Hospice/Palliative Care

Education

Lake Erie Col of Osteopathic Medicine, Bradenton, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Lower Cape Fear Hospice IncorporatedGroup PAC ID 3375445190, 26 clinicians

Lifecare Supportive Medicine IncorporatedGroup PAC ID 5092284182, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lower Cape Fear Lifecare Hospice, Wilmington, NC, CCN 341515

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Lower Cape Fear Hospice, Incorporated

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wilmington, NC
  • NPI 1790258234
  Medicare reassignment Care Compare group NPD
• Lifecare Supportive Medicine Incorporated

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wilmington, NC
  • NPI 1316804446
  Medicare reassignment Care Compare group
• Lower Cape Fear Hospice Incorporated

  • Case Management Agency
  • Wilmington, NC
  • NPI 1669012563
  NPD
• Lower Cape Fear Hospice Incorporated

  • Community Based Hospice Care Agency
  • Wilmington, NC
  • NPI 1912962697

  Hospice and Palliative Medicine

  NPD (past)

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

• Lower Cape Fear Hospice Incorporated

  • Community Based Hospice Care Agency
  • Wilmington, NC
  • NPI 1912962697
  Care Compare affiliation

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1235526989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 MCCORMICK DR STE 180",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745345",
            "telephone_number": "301-883-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 MCCORMICK DR STE 180",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745345",
            "telephone_number": "301-883-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MD",
            "license": "H0089766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal Touch Medical Spa LLC
• Holly Hoeller Pertmer, LCSW-C
• Joy Petway
• Elizabeth Kilmer Pfaffenroth, M.D.
• Tasha Renee Phillips-Wilson, MD, MS
• Yvette Darnell Phillips, LGSW
• Carolyn Dorothea Philson, BSN, RN, CDE
• Physical & Sports Rehab Inc
• Physicians RX Pharmacy LLC
• Physicians RX Pharmacy LLC

• Hospice and Palliative Medicine (Internal Medicine) Physician in Largo, MD
• Providers in Largo, MD by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.