Kimberly Vickery Phillips, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11021946 Issued in FL

Practice address

11512 Lake Mead Ave Unit 536
Jacksonville, FL 32256-9733

Phone

(904) 222-6103

NPI assigned

Mar 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

55.52 of 100Reported as group

Quality

67.92

Promoting interoperability

0

Improvement activities

40

Cost

67.15

Medicare enrollment (NPD)

Enrolled

Credentials

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 and National Provider Directory roles.

• Florida ENT Associates, Inc.

  dba South Florida ENT Associates, Inc.

  • Otolaryngology Physician
  • West Miami, FL
  • NPI 1184625733
  Medicare reassignment Care Compare group NPD
• Charles C Greene MD PHD PA

  dba Jacksonville ENT Surgery Center

  • Otolaryngology Physician
  • Jacksonville, FL
  • NPI 1457600769
  Medicare reassignment NPD
• Charles C Greene MD PHD PA

  dba Jacksonville ENT Surgery Center

  • Otolaryngology Physician
  • Jacksonville, FL
  • NPI 1609125913
  NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1275037186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11512 LAKE MEAD AVE UNIT 536",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569733",
            "telephone_number": "904-222-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KIMBERLY",
        "middle_name": "VICKERY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN266565",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11021946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrikki Phillips
• Hayley Brianna Phillips
• James Milton Phillips, M.D.
• Karen Phillips, LMHC
• Kavena Phillips
• Mark B Phillips, M.D.
• Michael Phillips, MD
• Michelle Everly Phillips
• Nancy Elanore Phillips, ANP-BC
• Nikola I Phillips

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.