DR. JOHN KENNETH PHILLIPS (NPI# 1518961580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518961580 |
| Entity Type | Individual |
| Full Name | DR. JOHN KENNETH PHILLIPS |
| Credential | M.D. |
| Practice Address |
3024 Stadium Blvd Jonesboro AR 72401-7415 |
| Mailing Address |
Po Box 1960 Po Box 1960 Jonesboro AR 72403-1960 |
| Practice Telephone | 8709345113 |
| Practice Fax Number | 8703923608 |
| Mailing Telephone | 8709368000 |
| Mailing Fax Number | 8709361043 |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2016-12-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
E0129 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 129236001 | 05 | |
| MO | 208891804 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659638815 | John Gray Phillips | Neurological Surgery | 224 Malibu Cv, Barefoot Beach, FL 34134-8536 | 2012-04-12 |
| 1306155320 | John Boyatt Phillips | Mechanotherapist | 726 E Hayden St, Pocatello, ID 83201-6226 | 2010-09-27 |
| 1831428788 | John Paul Phillips | Neurological Surgery | 6480 N Lake Blvd, Tahoe Vista, CA 96148-0379 | 2009-12-23 |
| 1376769760 | John Doss Phillips | Physical Therapist | 3409 Swisher Rd, Denton, TX 76208-7357 | 2007-04-17 |
| 1144359480 | John Lloyd Phillips | Dentist | 201 S Mcpherson Church Rd Ste 102, Fayetteville, NC 28303-4913 | 2007-03-04 |
| 1124160296 | John Martin Phillips II | Pediatrics | 1000 Breckenridge St Ste 300, Owensboro, KY 42303-0877 | 2007-02-13 |
| 1447327937 | John C Phillips | Internal Medicine | 1726 East Carson Street, Pittsburgh, PA 15203 | 2006-11-29 |
| 1255432738 | John Scott Phillips | Podiatrist | 883 London Ave Ste C, Marysville, OH 43040-9166 | 2006-09-26 |
| 1467559559 | John Michael Phillips | Physical Therapist | 700 River Avenue, Ste B, Iron Mountain, MI 49801 | 2006-09-20 |
| 1477567485 | John H Phillips | Internal Medicine | 1037 Sw 5th Ave, Ontario, OR 97914-3301 | 2006-07-27 |
| Street Address |
3024 STADIUM BLVD |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-7415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851725147 | Kelley Annette Williamson | Registered Nurse | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2013-08-22 |
| 1013275643 | Lauren Martin | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2012-05-02 |
| 1245522895 | Jeremy G Martin | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2011-05-13 |
| 1679891527 | Joshua Van Pettit | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2010-05-16 |
| 1255659546 | Richard Thomas Sheppard | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2010-05-11 |
| 1538487822 | Jonathan David Crafton | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2010-05-11 |
| 1497989958 | Toby A Stacy | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2009-05-12 |
| 1033372404 | Paul S Blumreich | Nurse Anesthetist, Certified Registered | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2008-07-07 |
| 1043410632 | Terry Ray Brewer Jr. | Registered Nurse | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2007-07-20 |
| 1609095934 | Reagan Baber | Anesthesiology | 3024 Stadium Blvd, Jonesboro, AR 82401-7415 | 2007-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578982526 | John Clifton Faircloth | Radiology | 800 S Chuch St, Suite 101, Jonesboro, AR 72401 | 2014-04-07 |
| 1083053615 | Caraway Medical Center | Radiology | 2929 S Caraway Rd Ste 1, Jonesboro, AR 72401-7335 | 2013-06-17 |
| 1184984155 | Holly Jo Gonzales | Radiology | 800 S Church St Ste 101, Jonesboro, AR 72401 | 2012-05-23 |
| 1922121698 | Wolf E Heberlein | Radiology | 3800 E Johnson Ave, Ste E, Jonesboro, AR 72401-1931 | 2007-04-09 |
| 1023074002 | Jeff Mullen | Radiology | 3100 Apache Dr, Suite C1, Jonesboro, AR 72401-7404 | 2006-04-26 |
| 1376506980 | St.bernards Imaging Center | Radiology | 1144 E Matthews Ave, Jonesboro, AR 72401-4314 | 2006-04-07 |
| 1609878867 | Richard R Reinholtz | Radiology | 225 E Jackson Ave, Jonesboro, AR 72401-3119 | 2005-06-01 |
| 1912136524 | Georgia Vascular Institute, LLC | Radiology | 7823 Spivey Station Blvd, Suite 300, Jonesboro, GA 30236-2886 | 2009-07-06 |
| 1679715130 | Ezekiel Elliott Shotts | Radiology | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2009-03-30 |
| 1356516330 | Angela V Frost | Radiology | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2008-04-29 |
| Find all providers in JONESBORO | ||||
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| 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.