MR. KENNETH L PHILLIPS JR. (NPI# 1366452401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366452401 |
Entity Type | Individual |
Full Name | MR. KENNETH L PHILLIPS JR. |
Credential | PA-C |
Practice Address |
15026 La Jolla Pl Colorado Springs CO 80921-2564 |
Practice Telephone | 7194885500 |
Practice Fax Number | 7194885500 |
Mailing Telephone | 7194885500 |
Mailing Fax Number | 7194885500 |
Enumeration Date | 2006-08-09 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
207 | CO | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CO | 63106523 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376801555 | Kenneth Gale Phillips | Preventive Medicine | 3415 Bridgefield Dr, Lakeland, FL 33803-5914 | 2012-04-25 |
1285709626 | Kenneth A Phillips | Optometrist | 314 Honesdale Road, Waymart, PA 18472-0310 | 2006-11-21 |
1629159017 | Kenneth Phillips | Emergency Medicine | 931 Nokomis Cir, Lancaster, TX 75146-5137 | 2006-10-18 |
1205932407 | Kenneth K Phillips Jr. | Podiatrist | 74090 El Paso, Suite 100, Palm Desert, CA 92260 | 2006-09-15 |
1144324575 | Kenneth Roswell Phillips | Internal Medicine | 16 Paul Ave, Warwick, RI 02886-7317 | 2006-09-07 |
1306852868 | Kenneth R Phillips | Dentist | 3165 Maplewood Ave, Winston Salem, NC 27103-3919 | 2006-08-01 |
1194221408 | Kenneth L Phillips | Counselor | 1058 S Governors Ave Ste 102, Dover, DE 19904-6920 | 2018-04-04 |
1871867119 | Kenneth David Phillips | Counselor | 8901 New Hampshire Ave, Silver Spring, MD 20903-3611 | 2012-03-05 |
1821368366 | Kenneth Phillips Sr. | Counselor | 777 Seaview Ave, Staten Island, NY 10305-3409 | 2011-12-30 |
1467739037 | Kenneth Dale Phillips | Registered Nurse | 12033 Agency Rd, Parker, AZ 85344-7718 | 2011-11-10 |
Street Address |
15026 LA JOLLA PL |
City | COLORADO SPRINGS |
State | CO |
Zip Code | 80921-2564 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588279699 | Play 4 Healing Pllc | Counselor | 13550 Northgate Estates Drive, Colorado Springs, CO 80921 | 2020-09-15 |
1740894039 | Emergency Medical Specialists, PC | Emergency Medicine | Meadowgrass Fsed - Md, 13510 Meadowgrass Dr, Colorado Springs, CO 80921 | 2020-09-03 |
1003420324 | Emergency Medical Specialists, PC | Emergency Medicine | Meadowgrass Fsed - App, 13510 Meadowgrass Dr, Colorado Springs, CO 80921 | 2020-09-03 |
1417519893 | Michelle Wright | Counselor | 11681 Voyager Parkway, Suite 150, Colorado Springs, CO 80921 | 2019-07-05 |
1780241083 | Lindsay Afton Barker | Counselor | Whole Kids Co., 11681 Voyager Pkwy, Ste 150, Colorado Springs, CO 80921 | 2019-05-22 |
1063076321 | Octavia Cormier | Counselor | 11681 Voyager Pkwy, Unit 150, Colorado Springs, CO 80921 | 2019-04-23 |
1225538630 | Northgate Family Chiropractic LLC | Chiropractor | 12245 Voyager Pkwy Ste 124, Colorado Springs, CO 80921 | 2018-02-13 |
1942712351 | Candace Grace Kaminski | Massage Therapist | 59 Avocet Loop, Colorado Springs, CO 80921 | 2017-10-26 |
1801319108 | Rebecca Freed | Physical Therapist | 13570 Northgate Estates Dr. Ste 100, Colorado Springs, CO 80921 | 2017-07-19 |
1174076582 | Jan L Wilkenson | Counselor | Heart Matters Counseling Center, 13550 Northgate Estates Drive, #200, Colorado Springs, CO 80921 | 2016-08-02 |
Find all providers in zip 80921 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851726681 | Lisa Kay Adams | Physician Assistant | 525 N Foote Ave Ste 202, Colorado Springs, CO 80909-4501 | 2013-09-11 |
1992945208 | Susan Gardiner Cump | Physician Assistant | 2940n Circle Dr, Colorado Springs, CO 80909-1160 | 2009-02-26 |
1356591762 | Johnathon D. Kupfner | Physician Assistant | 1584 Jackson Creek Parkway, Ste 120, Colorado Springs, CO 80132 | 2008-09-22 |
1427218916 | Gary Patrick Tocci | Physician Assistant | 9310 Sky King Dr, Colorado Springs, CO 80924-2020 | 2008-06-10 |
1619144888 | Laurie K Redding | Physician Assistant | 2130 Hollow Brook Dr, Suite 100, Colorado Springs, CO 80918-8400 | 2008-05-15 |
1760520746 | Donald Ray Lawson | Physician Assistant | 7667 Steward Ln, Colorado Springs, CO 80922-6327 | 2007-02-02 |
1245321140 | Kim Redinger | Physician Assistant | 1740 Pepperwood Dr, Colorado Springs, CO 80910-1525 | 2006-09-27 |
1770538159 | Jane D Brockhausen | Physician Assistant | 5799 Stetson Hills Blvd Ste 100, Colorado Springs, CO 80917-4223 | 2006-05-23 |
1033173851 | Michael E Young | Physician Assistant | 2222 N Nevada Ave Ste 5011, Colorado Springs, CO 80907-6819 | 2006-04-17 |
1295706075 | Cathy A. Hall | Physician Assistant | 1106 N Cascade Avenue, Colorado Springs, CO 80903 | 2006-01-30 |
Find all providers in COLORADO SPRINGS |
City | COLORADO SPRINGS |
Zip Code | 80921 |
Please comment or provide details below to improve the information on MR. KENNETH L PHILLIPS JR..
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.