Individual provider Active NPI

Jennifer Bromley Philips, MD

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1720377989
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2018-00087 Issued in NC
Practice address
905 Kenilworth Ave
Unit a
Charlotte, NC 28204-1015
Phone
(704) 355-3149
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 2018-00087 NC
Obstetrics & Gynecology Physician 207V00000X 2018-00087 NC Primary

Addresses

Primary practice location

905 Kenilworth Ave
Unit a
Charlotte, NC 28204-1015

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1025 Morehead Medical Dr
Ste 500 FL 5
Charlotte, NC 28204-2963
Phone (704) 355-3149

Other practice location 2

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866
Phone (704) 373-1813

Other practice location 3

251 Eastway Dr
Charlotte, NC 28213-7103
Phone (704) 446-9991

Other practice location 4

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1544

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jphilips402651@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180924003777 NC Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 8022339936 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Virginia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5863
Phone (704) 373-1813

905 Kenilworth Ave
Suite a
Charlotte, NC 28204-3584
Phone (704) 355-3149

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018-00087NCMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Obstetrics & Gynecology CurrentSince Mar 1, 2019 Accepting new patients
Carolinas Medical Center Obstetrics & Gynecology CurrentSince Sep 1, 2018 Accepting new patients
Carolinas Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Carolinas Physicians Network Inc Obstetrics & Gynecology CurrentSince Sep 22, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 1, 2019 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center Obstetrics & Gynecology Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 1, 2018 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 1, 2018 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1025 Morehead Medical Dr
Ste 500
Charlotte, NC 28204
Phone (704) 355-3149

905 Kenilworth Ave
Ste A
Charlotte, NC 28204
Phone (704) 355-3149

101 E Wt Harris Blvd
Ste 2320
Charlotte, NC 28262
Phone (704) 547-0858

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: jphilips402651@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1720377989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 KENILWORTH AVE",
            "address_2": "UNIT A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282041015",
            "telephone_number": "704-355-3149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 500 FL 5",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-3149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-373-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 Eastway Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282137103",
            "country_code": "US",
            "telephone_number": "704-446-9991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIPS",
        "first_name": "JENNIFER",
        "middle_name": "BROMLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2024-07-15",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NC",
            "license": "2018-00087",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2018-00087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jphilips402651@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "905 Kenilworth Ave",
            "address_2": "Unit A",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282041015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.