Robert L. Phillips, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16826 Issued in GA

Practice address

330 Peachtree St
Jesup, GA 31545-0244

Phone

(912) 427-6964

Fax

(912) 427-0591

NPI assigned

Aug 18, 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 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1831181403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 937",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315980937",
            "telephone_number": "912-427-6964",
            "fax_number": "912-427-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450244",
            "telephone_number": "912-427-6964",
            "fax_number": "912-427-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "16826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113528A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Paulino-Plummer
• Peachtree Family Medicine, LLC.
• Angela Perry, NP
• Pham General Surgery, P.C.
• Quynhanh H Pham, MD
• Ashley Pineda, OT
• Delaney Kay Pirkle, RPH
• Taylor Jordan Polander, MD
• Alyson Leigh Pond, LCSW
• Mia Popkin, MHS, OTR/L

• Family Medicine Physician in Jesup, GA
• Providers in Jesup, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.