Active NPI
Kevin C Phillips, MD
- Gynecology Physician
- Fort Smith, AR
National Provider Identifier
1881616258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- C-6868
- Practice address
- 6801 Rogers Ave
Fort Smith, AR 72903-4067 - Phone
- (479) 274-3400
- Fax
- (479) 274-3499
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | C-6868 | AR | Primary |
Addresses
Primary practice location
6801 Rogers Ave
Fort Smith, AR 72903-4067
Mailing address
PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 274-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115970001 | Medicaid | AR | |
| 160037823 | Other | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-6868 | AR | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Heart Center, PLC | Current | Accepting new patients |
Locations
4200 Jenny Lind Rd
Ste A
Fort Smith, AR 72901
Phone (479) 484-1010
Organizations & group practices 1
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.
-
- Clinic/Center
- Fort Smith, AR
- NPI 1912908492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441065600000",
"number": "1881616258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3528",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729133528",
"telephone_number": "479-274-2000",
"fax_number": "479-274-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 ROGERS AVE",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729034067",
"telephone_number": "479-274-3400",
"fax_number": "479-274-3499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "KEVIN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2015-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "AR",
"license": "C-6868",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115970001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "160037823",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.