Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Shadman Phillips, PA-C

Individual provider Surgical Physician Assistant · NPI 1194915496

Kelly Shadman Phillips, PA-C is a Physician Assistant in Cumming, Georgia. Qualified in 2007, 19 years ago. Accepts Medicare assignment. Licensed in Colorado, Georgia, North Carolina and Tennessee.

Years since qualifying
19
Licensed in
CO, GA, NC, TN
In the registry since
2007
Specialties on file
6
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1505 Northside Forsyth Blvd Ste 3500
Cumming, GA 30041
Phone: (770) 292-6500
Fax: (770) 292-6535
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0009629 (CO)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA0000001512 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 0010-03244 (NC)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 1512 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 1512 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 007088 (GA)

Record details

NPI number1194915496
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 1, 2007
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Cumming