Mary Katherine Phillips, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107708 Issued in FL

Practice address

2824 Mahan Dr Ste 1
Tallahassee, FL 32308-5429

Phone

(850) 558-1260

Fax

(850) 558-1298

NPI assigned

Jun 26, 2006

Last updated

Feb 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary K Vaughan Former name

Medicare fee-for-service enrollment

Enrolled in VA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Neurological ClinicGroup PAC ID 9032015946, 36 clinicians

Murray E Joiner Jr MD PCGroup PAC ID 4284637695, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Murray E Joiner Jr MD PC

  • Physical Medicine & Rehabilitation Physician
  • Roanoke, VA
  • NPI 1326089822

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Tallahassee Neurological Clinic

  • Neurological Surgery Physician
  • Tallahassee, FL
  • NPI 1982660569
  Medicare reassignment Care Compare group
• Murray E Joiner Jr MD PC

  • Physical Medicine & Rehabilitation Physician
  • Lynchburg, VA
  • NPI 1932746153
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carilion Medical Center

  dba Carilion Roanoke Memorial Hospital

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1891722096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD",
            "address_2": "SUITE 300",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084647",
            "telephone_number": "850-558-1260",
            "fax_number": "850-558-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 MAHAN DR STE 1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085429",
            "telephone_number": "850-558-1260",
            "fax_number": "850-558-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "VAUGHAN",
            "middle_name": "K",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carswella Odessa Phillips, ARNP
• Johnathan Phillips
• Kadrian Phillips
• Kendra Phillips, PHARMD
• Lauren N Phillips, CRNA
• Michelle Phillips
• Nancy E. Phillips, D.D.S
• Robert Edward Phillips, MD
• Physicians for a Community United for Research and Education LLC
• Gail M. Piazza, P.T.

• Physician Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.