Individual provider Active NPI

Karen Phillipps

  • Family Medicine Physician
  • Lake Wales, FL
National Provider Identifier
1487673901
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME88539 Issued in FL
Practice address
851 Chalet Suzanne Rd
Lake Wales, FL 33859-7759
Phone
(863) 679-9916
Fax
(863) 679-9826
NPI assigned
Jul 18, 2006
Last updated
Aug 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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 ME88539 FL Primary

Addresses

Primary practice location

851 Chalet Suzanne Rd
Lake Wales, FL 33859-7759

Mailing address

851 Chalet Suzanne Rd
Lake Wales, FL 33859-7759
Phone (863) 679-9916

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031211000055 FL Practitioner - Family Practice 7810893963 Reassigns benefits to 1 organization
Practice locations: Lake Wales, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

851 Chalet Suzanne Rd
Lake Wales, FL 33859-7759
Phone (863) 679-9916

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME88539FLMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: tlcfamilypractice.karenphillipps@120233.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1487673901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 CHALET SUZANNE RD",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338597759",
            "telephone_number": "863-679-9916",
            "fax_number": "863-679-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 CHALET SUZANNE RD",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338597759",
            "telephone_number": "863-679-9916",
            "fax_number": "863-679-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPPS",
        "first_name": "KAREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME88539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.