Jenny Lynn Phillips, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1299 Issued in TN

Practice address

1401 Carter Street Suite 102
Chattanooga, TN 37402

Phone

(423) 933-3397

Fax

(423) 933-3398

NPI assigned

Oct 4, 2006

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

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545
  Medicare reassignment NPD
• Chattanooga Complementary Care

  • Primary Care Clinic/Center
  • Chattanooga, TN
  • NPI 1164992665
  NPD (past) Authorized official
• Paul Grayson Smith, Jr., D.O., P.C.

  • Family Medicine Physician
  • Cleveland, TN
  • NPI 1952472185
  NPD
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1720174360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CARTER STREET SUITE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37402",
            "telephone_number": "423-933-3397",
            "fax_number": "423-933-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CARTER STREET SUITE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37402",
            "telephone_number": "423-933-3397",
            "fax_number": "423-933-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA1299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0140208",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3663990",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970027904",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "2000307",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0101",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "FP62706",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Wade Phillips, DPH
• Charles Vance Phillips IV, LMT
• Christy Elizabeth Phillips, CNNP
• Danielle Lea Phillips, AGACNP
• Gerald Lee Phillips III, PHARM.D.
• Jessica Phillips
• Justin Phillips, D.C.
• Kelly Phillips
• Kelly Leigh Phillips, APRN-BC, FNP
• Kourtnee Alexandrea Phillips, PHARMD

• Medical Physician Assistant in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.