NPIMap

Individual provider Active NPI

Charles K Phillips, MD

  • Family Medicine Physician
  • Newport News, VA
National Provider Identifier
1821089905
Registry record updated Feb 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101056085 Issued in VA
Practice address
12 Bruton Ave
Newport News, VA 23601-1602
Phone
(757) 594-4111
Fax
(757) 594-4115
NPI assigned
Oct 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101056085 VA Primary

Addresses

Primary practice location

12 Bruton Ave
Newport News, VA 23601-1602

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080102000484 VA Practitioner - Family Practice 3375623416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

12 Bruton Ave
Newport News, VA 23601-1602
Phone (757) 594-4111

Hospital & facility affiliations

  • Amedisys Home Health of Newport News Home health agency, Hampton, VA, CCN 497091
  • Riverside Home Health Home health agency, Newport News, VA, CCN 497467
  • Commonwealth Home Care Home health agency, Portsmouth, VA, CCN 497775
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Nov 1, 2007 Accepting new patients
Riverside Physician Services Inc CurrentSince Nov 1, 2007 Accepting new patients
Riverside Physician Services Inc Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

12 Bruton Ave
Newport News, VA 23601
Phone (757) 594-4111

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1130544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392422400000",
    "number": "1821089905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BRUTON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011602",
            "telephone_number": "757-594-4111",
            "fax_number": "757-594-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CHARLES",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-29",
        "last_updated": "2014-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101056085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.