Individual provider Active NPI

Kelly Leigh Phillips, APRN-BC, FNP

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1679539092
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000007169 Issued in TN
Practice address
2501 Citico Ave
Chattanooga, TN 37404-1127
Phone
(423) 697-2000
Fax
(423) 697-3510
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000007169 TN Primary

Addresses

Primary practice location

2501 Citico Ave
Chattanooga, TN 37404-1127

Mailing address

8435 Heron Cir
Ooltewah, TN 37363-9283
Phone (423) 344-4126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20061024000596 TN Practitioner - Nurse Practitioner 4082611611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Health Care System Inc.Group PAC ID 8628978210, 56 clinicians

Practice addresses (Care Compare)

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

Hospital & facility affiliations

  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
  • Commonspirit-Memorial Hospital-North Georgia Hospital, Ringgold, GA, CCN 110236

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000007169TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Group, PC Current Accepting new patients
Memorial Health Care System, Inc. CurrentSince Jan 1, 2011 Accepting new patients
Memorial Health Care System Inc. Current Accepting new patients

Locations

1949 Gunbarrel Rd
Ste 300
Chattanooga, TN 37421

2501 Citico Ave
Ofc
Chattanooga, TN 37404

2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318

2525 Desales Ave
Ste F1009
Chattanooga, TN 37404
Phone (423) 624-5200

400 Berywood Trl NW
Ste A
Cleveland, TN 37312
Phone (423) 697-3560

Interoperability endpoints

  • Direct secure messaging: kelly.phillips@direct.chattanoogaheart.nextgenshare.com

Organizations & group practices 3

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 3

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1679539092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8435 HERON CIR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639283",
            "telephone_number": "423-344-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KELLY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000007169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.