Individual provider Active NPI

Jefferson Dulin Phillips, MD

  • Emergency Medicine Physician
  • Rocky Mount, NC
National Provider Identifier
1841752094
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2022-01118 Issued in NC
Practice address
2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone
(434) 924-8485
NPI assigned
Apr 4, 2019
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2022-01118 NC Primary

Addresses

Primary practice location

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237

Mailing address

210 Towne Village Dr
Cary, NC 27513-8910
Phone (919) 859-3373

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
I20220708000778 NC Practitioner - Emergency Medicine 9335474204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Eastern Virginia Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 934-8171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
75.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-01118NCMDEmergency Medicine Physician
2020-01118NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Jul 20, 2022 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Jul 20, 2022 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine Current Accepting new patients
Wake Emergency Physicians PA Emergency Medicine PastSince Jul 10, 2022 Accepting new patients

Locations

210 Towne Village Dr
Cary, NC 27513
Phone (919) 348-4483

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

Interoperability endpoints

  • Direct secure messaging: jphillips851315@direct.unc.nchie.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1841752094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-859-3373",
            "fax_number": "434-982-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "434-924-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JEFFERSON",
        "middle_name": "DULIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2022-01118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.