Charles Kenneth Phillips Jr., FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP232230 Issued in GA

Practice address

4993 Russell Pkwy Ste 160-170
Warner Robins, GA 31088-8649

Phone

(478) 333-1550

NPI assigned

Aug 15, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1851174783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4993 RUSSELL PKWY STE 160-170",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888649",
            "telephone_number": "478-333-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4993 RUSSELL PKWY STE 160-170",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888649",
            "telephone_number": "478-333-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CHARLES",
        "middle_name": "KENNETH",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP232230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Lee Peterson Moss, NP-C
• Patrice Peterson, MT
• Jodi Lynne Pettygrove, FNP
• John Jeremy Pettygrove, DC
• Marc A Phagan, CRNA
• Derrick D. Phillips, M.D.
• Stacey Phillips, LAPC
• Toniyah Phillips
• Phoenix Center Behavioral Health Services
• Phoenix Center Community Service Board

• Family Nurse Practitioner in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.