Lilliot Phillips, AG-ACNP
Individual provider Active NPI Nurse Practitioner · Callahan, FL
NPI 1669951455 · NPPES record last updated Feb 15, 2021
Key facts
- NPI
- 1669951455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN1617712 (FL)
- Practice address
- 54123 Lisa Dr
Callahan, FL 32011-5989 - Phone
- (904) 955-3062
- NPI assigned
- Aug 13, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Intensive Care Consortium Inc
Practice addresses (Care Compare)
119 Oakfield Dr
Brandon, FL 33511-5779
Phone (561) 997-0821
Hospital & facility affiliations
- HCA Florida South Shore Hospital
- HCA Florida Brandon Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200228000250 | FL | Practitioner - Nurse Practitioner | 7810237989 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intensive Care Consortium Inc | Nurse Practitioner | Current |
Accepting new patients |
| Intensivist Medicine Services of FL, LLC | Current |
Accepting new patients | |
| Pulmonary Physicians of South Florida LLC | Current |
Accepting new patients |
Locations
119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150
8600 SW 92nd St
Ste 204A
Miami, FL 33156
Phone (305) 436-9933
5000 University Dr
Miami, FL 33146
Phone (305) 666-2111
2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015
4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145
2901 W Swann Ave
Fl S
Tampa, FL 33609
Phone (813) 873-6400
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN1617712 | FL | Yes |
Addresses
Primary practice location
54123 Lisa Dr
Callahan, FL 32011-5989
Mailing address
54123 Lisa Dr
Callahan, FL 32011-5989
Phone (904) 955-3062
Other providers in Callahan, FL
- Bo K Nguyen
- Don Anh Nguyen
- North Florida Senior Living LLC
- Nikata Arvind Patel
- Chester Howard Penn
- Joanna Picard
- Barbara Ann Pierce
- Jordan Powell
- Casey J Price
- Kiersten Lea Prince
All providers in Callahan, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.