Individual provider Active NPI

Jessamyn C Phillips, NP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1386277861
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013355 Issued in CA
Practice address
1500 21St St
Sacramento, CA 95811-5216
Phone
(916) 443-3299
NPI assigned
Feb 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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 95013355 CA Primary

Addresses

Primary practice location

1500 21St St
Sacramento, CA 95811-5216

Mailing address

1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299

Other practice location 1

4610 X St
Sacramento, CA 95817-2200
Phone (916) 734-2145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20211014003161 CA Practitioner - Nurse Practitioner 8022422518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cares Community HealthGroup PAC ID 2769418151, 45 clinicians

Practice addresses (Care Compare)

1442 Ethan Way
Sacramento, CA 95825-2214
Phone (916) 443-3299

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95013355CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cares Community Health CurrentSince Jun 17, 2021 Accepting new patients
Cares Community Health CurrentSince Jun 17, 2021 Accepting new patients

Locations

1500 21st St
Sacramento, CA 95811
Phone (916) 443-3299

1442 Ethan Way
Ste 100
Sacramento, CA 95825
Phone (916) 443-3299

1442 Ethan Way
Sacramento, CA 95825
Phone (916) 443-3299

Interoperability endpoints

  • Direct secure messaging: jphillips315410@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1386277861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-443-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-443-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 X St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172200",
            "country_code": "US",
            "telephone_number": "916-734-2145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JESSAMYN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.