Individual provider Active NPI

Michelle Everly Phillips

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1487466074
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ARNP11037283 Issued in FL
Practice address
4655 Salisbury Rd Ste 220
Jacksonville, FL 32256-0959
Phone
(904) 570-9404
Fax
(904) 900-2224
NPI assigned
Jan 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ARNP11037283 FL Primary

Addresses

Primary practice location

4655 Salisbury Rd Ste 220
Jacksonville, FL 32256-0959

Mailing address

36644 Dyal Rd
Callahan, FL 32011-3483
Phone (904) 338-6948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250211003377 FL Practitioner - Nurse Practitioner 8123558764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Choice Operating Company LLCGroup PAC ID 3779991542, 60 clinicians

Practice addresses (Care Compare)

4655 Salisbury Rd
Suite 220
Jacksonville, FL 32256-0959
Phone (904) 570-9404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP11037283FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
My Choice Operating Company LLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

4655 Salisbury Rd
Ste 220
Jacksonville, FL 32256
Phone (904) 570-9404

4655 Salisbury Rd
Ste 110
Jacksonville, FL 32256
Phone (904) 570-9404

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 8

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": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1487466074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36644 DYAL RD",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113483",
            "telephone_number": "904-338-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 SALISBURY RD STE 220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560959",
            "telephone_number": "904-570-9404",
            "fax_number": "904-900-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MICHELLE",
        "middle_name": "EVERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ARNP11037283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.