Individual provider Active NPI

Kristi M Phillips, NP-C

  • Adult Health Nurse Practitioner
  • Sterling, VA
National Provider Identifier
1952641433
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024175482 Issued in VA
Practice address
22000 Dulles Retail PLZ Ste 124
Sterling, VA 20166-2515
Phone
(703) 282-5338
NPI assigned
Feb 21, 2013
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024175482 VA Primary

Addresses

Primary practice location

22000 Dulles Retail PLZ Ste 124
Sterling, VA 20166-2515

Mailing address

22908 Bollinger Ter
Brambleton, VA 20148-1733
Phone (601) 942-7502

Other identifiers 1

IdentifierTypeStateIssuer
0024175482OtherVAVA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD, DC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180709001288 VA Practitioner - Nurse Practitioner 6709021934 Reassigns benefits to 2 organizations
I20180806003403 MD Practitioner - Nurse Practitioner 6709021934 Reassigns benefits to 1 organization
I20230502000646 DC Practitioner - Nurse Practitioner 6709021934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 5, 2018 Accepting new patients
Atlantic Knee Restoration & Regenerative Medicine - Richmond CurrentSince Jun 1, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince May 5, 2018 Accepting new patients
Jackson Anesthesia Pain Center, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Newbridge Anesthesia LLC PastSince Sep 6, 2017 Accepting new patients
Newbridge Spine and Pain Center of Virginia LLC PastSince Sep 6, 2016 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

196 Thomas Johnson Dr
Ste 215
Frederick, MD 21702
Phone (301) 668-9988

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

8644 Sudley Rd
#220
Manassas, VA 20110

7481 Right Flank Rd
Ste 100
Mechanicsvlle, VA 23116
Phone (804) 616-4515

Interoperability endpoints

  • Direct secure messaging: kristi.phillips.1@32911.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1952641433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22908 BOLLINGER TER",
            "city": "BRAMBLETON",
            "state": "VA",
            "postal_code": "201481733",
            "telephone_number": "601-942-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22000 DULLES RETAIL PLZ STE 124",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201662515",
            "telephone_number": "703-282-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KRISTI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024175482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENSE",
            "identifier": "0024175482",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.