Kaitlin Marie Fahey Phillips

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12695 Issued in TX

Practice address

202 E Jefferson Ave
Whitney, TX 76692-2398

Phone

(254) 694-2221

Fax

(254) 694-9978

NPI assigned

Aug 1, 2019

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shenandoah Memorial Hospital, Inc. 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shenandoah Memorial Hospital Hospital, Woodstock, VA, CCN 491305
• Warren Memorial Hospital Hospital, Front Royal, VA, CCN 490033
• Winchester Medical Center Hospital, Winchester, VA, CCN 490005

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kphillips744389@valleyhealth.direct-ci.com

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.

• Shenandoah Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Woodstock, VA
  • NPI 1952417735

  VA

  Medicare reassignment Care Compare group NPD (past)
• Shenandoah Memorial Hospital Inc.

  • Rural Health Clinic/Center
  • New Market, VA
  • NPI 1740711472
  Care Compare group NPD
• Shenandoah Memorial Hospital Inc.

  • Rural Health Clinic/Center
  • Woodstock, VA
  • NPI 1053848069
  Care Compare group
• Shenandoah Memorial Hospital, Inc.

  • Critical Access Hospital
  • Woodstock, VA
  • NPI 1033166442
  Care Compare group
• Shenandoah Memorial Hospital, Inc.

  • Surgery Physician
  • Woodstock, VA
  • NPI 1407357015
  Care Compare group
• Shenandoah Memorial Hospital, Inc.

  • Family Medicine Physician
  • Strasburg, VA
  • NPI 1710494331
  Care Compare group

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

• Shenandoah Memorial Hospital, Inc.

  • Critical Access Hospital
  • Woodstock, VA
  • NPI 1033166442

  Hospital

  Care Compare affiliation
• Warren Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Front Royal, VA
  • NPI 1427085232

  Hospital

  Care Compare affiliation
• Winchester Medical Center

  • General Acute Care Hospital
  • Winchester, VA
  • NPI 1619928017

  Hospital

  Care Compare affiliation
• Winchester Medical Center

  • Clinical Medical Laboratory
  • Winchester, VA
  • NPI 1790024909

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1982258414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E JEFFERSON AVE",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922398",
            "telephone_number": "254-694-2221",
            "fax_number": "254-694-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E JEFFERSON AVE",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922398",
            "telephone_number": "254-694-2221",
            "fax_number": "254-694-9978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Posey Ave",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "TX",
            "postal_code": "766341200",
            "country_code": "US",
            "telephone_number": "254-675-8621",
            "fax_number": "254-675-2254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 S Main St",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "VA",
            "postal_code": "226641154",
            "country_code": "US",
            "telephone_number": "540-459-1383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9166 N Congress St",
            "address_purpose": "LOCATION",
            "city": "New Market",
            "state": "VA",
            "postal_code": "228449422",
            "country_code": "US",
            "telephone_number": "540-459-1340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KAITLIN",
        "middle_name": "MARIE FAHEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA12695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kphillips744389@soc.inova.org",
            "affiliation": "N",
            "address_1": "759 S Main St",
            "city": "Woodstock",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226641154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kphillips744389@soc.inova.org",
            "affiliation": "N",
            "address_1": "9166 N Congress St",
            "city": "New Market",
            "state": "VA",
            "country_code": "US",
            "postal_code": "228449422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Ann Page, LMFT ASSOCIATE
• Scott Pasnik, LPC
• Amber Renee Pavelka, PT, DPT
• Peters and Todar, PLLC
• Bill B Peters, PHD, LCSW
• Clayton Pickering, DO
• Gina Pierce
• Aaron Prasifka
• Pyramid Healthcare Corp
• Randall D Henderson DO PA

• All providers in Whitney, TX
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.