Kimberly Young Phillips, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

051711 Issued in GA

Legal business name

KIMBERLY YOUNG PHILLIPS, MD, PC

Practice address

142 Hospital Perimeter Rd
Eatonton, GA 31024-8502

Phone

(706) 485-1145

Fax

(706) 485-6025

NPI assigned

Aug 7, 2006

Last updated

May 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Young Phillips, MDNPI 1477562379

Title

Owner, President

Phone

(706) 485-1145

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Young Phillips, MD

  • Family Medicine Physician
  • Eatonton, GA
  • NPI 1477562379
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1871502799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 HOSPITAL PERIMETER RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310248502",
            "telephone_number": "706-485-1145",
            "fax_number": "706-485-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 HOSPITAL PERIMETER RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310248502",
            "telephone_number": "706-485-1145",
            "fax_number": "706-485-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY YOUNG PHILLIPS, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "706-485-1145",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "051711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE8801",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "893856",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "051711",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahagony Johnson, CCC-SLP
• Susan Leigh Jones, M.D.
• Journey to Joy & Discovery Counseling
• Cynthia Marie Killip, NCPRSS, PR
• Linda Calvo Kimbell, LCSW
• Kingdom C & M Devices Inc.
• Brittney Knowlton, DC
• Whitney Knowlton, PA
• Ajay Kumar, M.D.
• Rakesh Kumar, MD

• Family Medicine Physician in Eatonton, GA
• Providers in Eatonton, 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 May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.