MRS. KARYNTHIA A PHILLIPS MSM,PA-C, NPI 1174518104 — NASHVILLE (TN)

NPI 1174518104

14+ Years Experience Individual

MRS. KARYNTHIA A PHILLIPS MSM,PA-C

09/15/2005
PROVIDER ENUMERATION DATE
11/15/2012
LAST UPDATE DATE
1174518104
NPI NUMBER

About MRS. KARYNTHIA A PHILLIPS

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

MRS. KARYNTHIA A PHILLIPS is a provider established in NASHVILLE, TN. The NPI number of MRS. KARYNTHIA A PHILLIPS is 1174518104 and was assigned on 09/15/2005. The practitioners primary taxonomy code is: 363AM0700X with license number: PA841 TN .

Mailing address

  • City: NASHVILLE
  • State: TN
  • Postal code: 372173341
  • Phone: 6158336898
  • Fax: 6158336895
  • Address: 2275 MURFREESBORO PIKE
  • Address 2: SUITE 109-110

Primary Practice Address

  • Region : NASHVILLE, TN
  • NPI : 1174518104
  • Phone : 6158336898
  • Fax : 6158336895
  • Postalcode : 372173341
  • Address : 2275 MURFREESBORO PIKE SUITE 109-110

Additional identifiers

  • Identifier: 36692701
  • Code / Type : 5 - MEDICAID
  • Identifier state : TN

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 4137131
  • Code / Type : 1 - other
  • Identifier state : TN
  • Identifier issuer : DUE WEST BCBS

Provider taxonomy - Physician Assistant

  • Taxonomy code: 363AM0700X
  • License number: PA841
  • License state: TN

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • MRS. KARYNTHIA A PHILLIPS MSM,PA-C
  • Address : 2275 MURFREESBORO PIKE SUITE 109-110
  • Region : NASHVILLE, TN
  • NPI : 1174518104
  • Phone : 6158336898
  • Fax : 6158336895
  • Postalcode : 372173341

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address2275 MURFREESBORO PIKE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 109-110
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNASHVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTN
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code372173341
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6158336898
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6158336895
The fax number associated with the location address of the provider being identified.
NPI1174518104
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1363AM0700X
Provider Enumeration Date09/15/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated11/15/2012
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MRS. KARYNTHIA A PHILLIPS
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address2275 MURFREESBORO PIKE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 109-110
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameNASHVILLE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code372173341
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6158336898
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6158336895
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1363AM0700X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Physician Assistant
Provider License Number 1PA841
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1TN
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 136692701
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1TN
Other Provider Identifier State #1
Other Provider Identifier 24137131
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2TN
Other Provider Identifier State #2
Other Provider Identifier Issuer 2DUE WEST BCBS
Other Provider Identifier Issuer #2
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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