Kimberly Young Phillips, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

051711 Issued in GA

Practice address

142 Hospital Perimeter Rd
Eatonton, GA 31024-8502

Phone

(706) 485-1145

Fax

(706) 485-6025

NPI assigned

Aug 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Mercer University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Putnam General Hospital Hospital, Eatonton, GA, CCN 111313
• St Marys Good Samaritan Hospital Hospital, Greensboro, GA, CCN 111329
• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018
• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHFAAA/Endpoint/CHFAAA

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.

• Kimberly Young Phillips, MD, PC

  • Family Medicine Physician
  • Eatonton, GA
  • NPI 1871502799
  Medicare reassignment NPD Authorized official
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Family Medical Associates of Lake Oconee PC

  • Family Medicine Physician
  • Greensboro, GA
  • NPI 1790861581
  NPD (past)
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Family Medicine

  NPD (past)

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

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation
• Piedmont Newton Hospital, Inc.

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation
• Putnam General Hospital Authority

  • Critical Access Hospital
  • Eatonton, GA
  • NPI 1386670834
  Care Compare affiliation
• St. Mary'S Good Samaritan Hospital, Inc.

  • Critical Access Hospital
  • Greensboro, GA
  • NPI 1346209137
  Care Compare affiliation

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1477562379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 HOSPITAL PERIMETER RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310248502",
            "telephone_number": "706-485-1145",
            "fax_number": "706-485-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 HOSPITAL PERIMETER RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310248502",
            "telephone_number": "706-485-1145",
            "fax_number": "706-485-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KIMBERLY",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "051711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00322240",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "051711",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000954786C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "20-2256065",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE8801",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Patrick, DC
• Peaceful Purpose Hospice
• Peaceful Purpose Hospice of Georgia LLC
• Performance Chiropractic & Wellness
• Diane Peterman, MD
• Phoenix Counseling and Wellness, LLC
• Precious Jem Counseling and Youth Services
• Pretty in Pink Boutique LLC
• Cassandra T Price, FNP-BC
• Publix Super Markets Inc

• Family Medicine Physician in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.