Kassandra Jane Phillips, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0102206067 Issued in VA

Practice address

2937 Fox Chase LN
Midlothian, VA 23112-4400

Phone

(804) 372-3473

NPI assigned

Jun 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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 Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmilam@yourcarecommunity.org
• Direct secure messaging: kassandra.phillips@sdhs.directbygreenway.com

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.

• Southern Dominion Health System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Victoria, VA
  • NPI 1295706588
  Medicare reassignment NPD
• Southern Dominion Health System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dinwiddie, VA
  • NPI 1487867206
  NPD
• Southern Dominion Health System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Victoria, VA
  • NPI 1497969091
  NPD
• Southern Dominion Health System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Amelia Court House, VA
  • NPI 1700099512
  NPD
• Katebowersmd

  • Pediatrics Physician
  • Midlothian, VA
  • NPI 1982191540
  NPD (past)
• Southern Dominion Health System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Emporia, VA
  • NPI 1982817706
  NPD (past)
• Positive Development of California PC

  • Psychologist
  • Whittier, CA
  • NPI 1538769617
  NPD (past)

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1861698342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2937 FOX CHASE LN",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124400",
            "telephone_number": "804-372-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 FOX CHASE LN",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124400",
            "telephone_number": "804-372-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KASSANDRA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080I0007X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Clinical & Laboratory Immunology",
            "state": "WV",
            "license": "2271",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102206067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810015268",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Rose Peterson, M.D.
• Tiannie Phan, DDS
• Devan Taylor Phelps
• Ben D Phillips, MD
• Jennifer Phillips
• Michele Jane Phillips, PA-C
• Amanda Phung, PT, DPT
• Physical Medicine Associates LTD
• Isabella Piccininni, RN
• Christopher Picklesimer, PHARMD

• Pediatrics Physician in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.