Individual provider Active NPI

Allison Gayle Phillips, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Campbellsville, KY
National Provider Identifier
1760469134
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3002239 Issued in KY
Practice address
2038 Smith Ridge Rd
Campbellsville, KY 42718-7601
Phone
(270) 283-3456
Fax
(877) 463-0363
NPI assigned
Dec 28, 2005
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3002239 KY
Family Nurse Practitioner 363LF0000X 3002239 KY
Women's Health Nurse Practitioner 363LW0102X 3002239 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3002239 KY Primary

Addresses

Primary practice location

2038 Smith Ridge Rd
Campbellsville, KY 42718-7601

Mailing address

2038 Smith Ridge Rd
Campbellsville, KY 42718-7601
Phone (270) 283-3456

Other practice location 1

640 Watertower Byp
Campbellsville, KY 42718-8657
Phone (502) 262-2887

Other practice location 2

407 East First St
Campbellsville, KY 42718
Phone (270) 465-4191

Other names 1

  • Allison Gayle Mardis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Trail District Health Department Past Accepting new patients
Lake Cumberland District Health Department Past Accepting new patients
Lake Cumberland District Health Department Past Accepting new patients
Lake Cumberland District Health Department Past Accepting new patients
Lincoln Trail District Health Department Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1760469134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 SMITH RIDGE RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187601",
            "telephone_number": "270-283-3456",
            "fax_number": "877-463-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2038 SMITH RIDGE RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187601",
            "telephone_number": "270-283-3456",
            "fax_number": "877-463-0363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Watertower Byp",
            "address_purpose": "LOCATION",
            "city": "Campbellsville",
            "state": "KY",
            "postal_code": "427188657",
            "country_code": "US",
            "telephone_number": "502-262-2887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "407 East First St",
            "address_purpose": "LOCATION",
            "city": "Campbellsville",
            "state": "KY",
            "postal_code": "42718",
            "country_code": "US",
            "telephone_number": "270-465-4191",
            "fax_number": "270-789-3873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ALLISON",
        "middle_name": "GAYLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3002239",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3002239",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3002239",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3002239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "MARDIS",
            "middle_name": "GAYLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.