Individual provider Active NPI

Amy Phillips

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1447729611
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP139352 Issued in TX
Practice address
4330 Medical Dr Ste 105
San Antonio, TX 78229-3353
Phone
(210) 692-7228
NPI assigned
Nov 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 638550 TX
Gerontology Nurse Practitioner 363LG0600X AP139352 TX
Acute Care Nurse Practitioner 363LA2100X AP139352 TX Primary

Addresses

Primary practice location

4330 Medical Dr Ste 105
San Antonio, TX 78229-3353

Mailing address

7142 San Pedro Ave Ste 120
San Antonio, TX 78216-6256
Phone (210) 692-7228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190104001988 TX Practitioner - Nurse Practitioner 3678819158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4330 Medical Dr
Suite 105
San Antonio, TX 78229-3353
Phone (210) 692-7228

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Merit-based Incentive Payment System (MIPS)

Final score
85.76 of 100Reported as group
Quality
67.88
Promoting interoperability
87
Improvement activities
40
Cost
78.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
638550TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Kidney Disease Center Physicians Group, P.L.L.C. CurrentSince Jan 17, 2022 Accepting new patients

Locations

4330 Medical Dr
Ste 105
San Antonio, TX 78229
Phone (210) 692-7228

7142 San Pedro Ave
Ste 120
San Antonio, TX 78216
Phone (210) 481-7453

10010 Rogers Xing
Ste 210
San Antonio, TX 78251
Phone (210) 549-3524

Organizations & group practices 1

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": "1542412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1447729611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-692-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293353",
            "telephone_number": "210-692-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-17",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "638550",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP139352",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP139352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.