Mark Stephen Phillips, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08167 Issued in NC

Practice address

160 Kimel Forest Dr Ste 100
Winston Salem, NC 27103-6084

Phone

(336) 883-0029

Fax

(336) 283-6518

NPI assigned

Jun 15, 2018

Last updated

Mar 7, 2025By the provider in NPPES

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

Other identifiers 1

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

Specialty

Physician Assistant

Education

Wake Forest University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethany Medical CenterGroup PAC ID 4486614575, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mphillips2977023@carolinashealthcaresystem.direct-ci.com

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.

• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Bethany Medical Center

  • Internal Medicine Physician
  • Kernersville, NC
  • NPI 1861049231
  NPD
• Bethany Medical Center, PA

  • Family Medicine Physician
  • High Point, NC
  • NPI 1508459306
  NPD
• Bethany Medical Center

  dba Bethany Medical Pain Clinic

  • Internal Medicine Physician
  • Winston Salem, NC
  • NPI 1528554631
  NPD (past)
• Bethany Medical Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Kernersville, NC
  • NPI 1619398997
  NPD (past)
• Bethany Medical Center

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1710453550
  NPD (past)
• Bethany Medical Center, PA

  • Cardiovascular Disease Physician
  • High Point, NC
  • NPI 1174722391
  NPD (past)

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

• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Winston East Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1336633106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 KIMEL FOREST DR STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036084",
            "telephone_number": "336-883-0029",
            "fax_number": "336-283-6518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5093 University Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271066085",
            "country_code": "US",
            "telephone_number": "336-883-0029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC#",
            "identifier": "397730042",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Bennett Phillips
• Justine Phillips, PHARMD
• Kenneth R Phillips, DDS
• Kristen Mary Phillips, LM, CPM
• Maggie Phillips, MD
• Nailah Zakiya Phillips
• Richard Brock Phillips, PA-C
• Sheila Williams Phillips, LCSWA
• Teneisha Candice Phillips
• Tammy Phinney, CRNA

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.