Individual provider Active NPI

Kendall Phillips, FNP

  • Family Nurse Practitioner
  • Hugo, OK
National Provider Identifier
1346819802
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
204182 Issued in OK
Practice address
111 N 3Rd St
Hugo, OK 74743-4001
Phone
(580) 372-2819
NPI assigned
Jun 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 204182 OK Primary

Addresses

Primary practice location

111 N 3Rd St
Hugo, OK 74743-4001

Mailing address

111 N 3Rd St
Hugo, OK 74743-4001
Phone (803) 722-8195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20211117003167 OK Practitioner - Nurse Practitioner 9234528977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 N 3Rd St
Hugo, OK 74743-4001
Phone (580) 372-2819

Hospital & facility affiliations

  • Mays Housecall Home Health of Antlers, LLC Home health agency, Antlers, OK, CCN 377187
  • Cypress Home Care Home health agency, Hugo, OK, CCN 377699
  • Choctaw Memorial Hospital Hospital, Hugo, OK, CCN 370100

Merit-based Incentive Payment System (MIPS)

Final score
48.36 of 100Reported as group
Quality
69.37
Improvement activities
0
Cost
53.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204182OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phillips Family Medical Clinic LLC Family CurrentSince Mar 1, 2025 Accepting new patients
Restore Family Medical Clinic II Primary Care CurrentSince Aug 1, 2023 Accepting new patients
Choctaw County City of Hugo Hospital Authority Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

111 N 3rd St
Hugo, OK 74743
Phone (580) 372-2819

Organizations & group practices 4

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 3

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": "1624147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1346819802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N 3RD ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434001",
            "telephone_number": "803-722-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N 3RD ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434001",
            "telephone_number": "580-372-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KENDALL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-20",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "204182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hugo, OK

Sources for this page

Verify at the official NPI Registry.