John Keith Phillips, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101231142 Issued in VA

Practice address

4080 Lafayette Center Dr
Suite 170
Chantilly, VA 20151-1247

Phone

(703) 766-5040

Fax

(703) 766-5047

NPI assigned

Sep 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1699760371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791128",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791128",
            "telephone_number": "703-391-2030",
            "fax_number": "703-273-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 LAFAYETTE CENTER DR",
            "address_2": "SUITE 170",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511247",
            "telephone_number": "703-766-5040",
            "fax_number": "703-766-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHN",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101231142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05647398",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00015942",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hiep D Pham, DDS
• Jennifer Pham, D.M.D, M.S
• Kimberly Pham, BEHAVIOR TECHNICIAN
• Truc T Phan, D.D.S
• Atul Edward Philips
• Tammy Lynn Phipps, OTR
• Physicians Premiere Weight & Wellness Center, P.L.L.C.
• Physiotherapy Associates, Inc.
• Lisa Lynn Pike-Buchanan, SC.M.
• Anthony Joseph Pinizzotto, PHD

• Family Medicine Physician in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.