Jacqueline Yevette Phillips

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116892 Issued in FL

Practice address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915

Phone

(305) 466-9988

NPI assigned

Jul 13, 2023

Last updated

Jul 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• QSM-FL, Inc

  • Surgery Physician
  • Hollywood, FL
  • NPI 1609318617
  Medicare reassignment

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1619656006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7490 FRONT BEACH ROAD",
            "address_2": "UNIT 1127",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32407",
            "telephone_number": "706-366-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "305-466-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JACQUELINE",
        "middle_name": "YEVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Aju Philip, APRN
• Sherica Philippe, ARNP. FNP-C
• Athlene Phillips
• Barnell Phillips III, M.D.
• Basil Phillips
• Jonathan Phillips, PHARMD
• Kaitlyn Kristi Phipps
• Physical Therapy Institute and Aquatic Rehab, Inc.
• Physician Associates of Broward Inc
• Physician Partnership Alliance LLC

• Physician Assistant in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.