Mark B Phillips, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME0047040 Issued in FL

Practice address

4545 Emerson Expressway
Jacksonville, FL 32207

Phone

(904) 399-2600

NPI assigned

Oct 17, 2006

Last updated

Oct 16, 2013By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mark B Phillips M.D., P.a.

  • Anesthesiology Physician
  • Jacksonville, FL
  • NPI 1003997271
  NPD (past)
• Medical Partners Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
  • NPI 1093772667
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1912088196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 EMERSON EXPRESSWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-399-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME0047040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000378452D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274660300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayley Brianna Phillips
• James Milton Phillips, M.D.
• Karen Phillips, LMHC
• Kavena Phillips
• Kimberly Vickery Phillips, NP
• Michael Phillips, MD
• Michelle Everly Phillips
• Nancy Elanore Phillips, ANP-BC
• Nikola I Phillips
• Patricia M Phillips

• Anesthesiology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.