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Deactivated NPI 1497099667 Deactivated / Inactive NPI Female Practitioner

Kathleen Phillips , NP

Nurse Practitioner • Fraser, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kathleen Phillips has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 12, 2012
NPI Deactivation Date December 10, 2018
Total Practice Duration ~6 Years of Practice (2012 – 2018)

Professional Overview & Biography Verified Profile Summary

Kathleen Phillips, NP was a registered Nurse Practitioner practicing in Fraser, MI. Throughout an active medical career spanning 6 years, Kathleen Phillips provided care at the practice location at 17717 MASONIC until profile deactivation on 2018-12-10.

Historical Medicare Part B clinical services included established patient outpatient office visit, insertion of needle into vein for collection of blood sample, blood test, clotting time. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

17717 Masonic

Fraser, MI 480263158

Telephone 5862940600
Fax 5862942525
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Fraser, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.8 Yrs
Regional Practice Density
2 Specialists

Practicing in Fraser, MI (3626 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
60.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
378 292 $98.00 $59.73
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
203 143 $142.00 $87.86
36415 Insertion of needle into vein for collection of blood sample
133 109 $16.00 $2.92
85610 Blood test, clotting time
90 16 $12.00 $4.75
81002 Urinalysis, manual test
80 75 $15.00 $3.37
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention
41 22 $43.00 $15.73
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
35 35 $263.37 $95.16
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)
30 30 $65.00 $16.20
93000 Routine ekg using at least 12 leads including interpretation and report
16 16 $76.00 $12.94
G0444 Annual depression screening, 5 to 15 minutes
13 13 $41.00 $14.52
94640 Inhalation treatment for airway obstruction or sputum production
13 12 $57.00 $14.75

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License MI 4704177732

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

38 Associated Practitioners
Dr. Jodi Ralston , MD

Emergency Medicine

NPI 1013956119

Doctor of Medicine (M.D.)

Dr. Daniel Wilkerson , MD

Emergency Medicine

NPI 1043259682

Doctor of Medicine (M.D.)

Simon Katrib

Emergency Medicine

NPI 1073896346
Dr. Ross Heller , MD

Emergency Medicine

NPI 1083614333

Doctor of Medicine (M.D.)

Dr. Chad Kovala , DO

Emergency Medicine

NPI 1114160249

Doctor of Osteopathic Medicine (D.O.)

Dr. Elizabeth Bascom , MD

Emergency Medicine

NPI 1215977343

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 10, 2018

Record deactivated on December 10, 2018

NPI Profile Active November 12, 2012

NPI status registered as active in NPPES database

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Updated Practice Location November 12, 2012

Registered at 17717 MASONIC, FRASER, MI 480263158 (Tel: 5862940600)

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Updated Business Mailing Address November 12, 2012

Registered at 17717 MASONIC, FRASER, MI 480263158 (Tel: 5862940600)

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Provider Name / Credentials Updated November 12, 2012

Recorded as KATHLEEN PHILLIPS, N.P.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 12, 2012

Nurse Practitioner (License #4704177732 in MI)

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Initial NPI Registration & Enumeration November 12, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497099667
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 12, 2012
Last Update: November 12, 2012
Deactivation Date: December 10, 2018

Mailing Address

17717 Masonic

Fraser, MI 480263158

Phone: 5862940600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.