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

Kimberly Vickery Phillips, NP

Individual provider Nurse Practitioner · NPI 1275037186

Kimberly Vickery Phillips, NP is a Nurse Practitioner in Jacksonville, Florida. Qualified in 2017, 9 years ago. Practices with Florida ENT Associates Inc, a 159-clinician group and accepts Medicare assignment. Licensed in Florida and Georgia.

Years since qualifying
9
Licensed in
FL, GA
In the registry since
2018
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

11512 Lake Mead Ave Unit 536
Jacksonville, FL 32256-9733
Phone: (904) 222-6103
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 11021946 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence RN266565 (GA)

Record details

NPI number1275037186
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 23, 2018
Last updated in NPPESDecember 31, 2024
Certification dateDecember 31, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Florida Ent Associates Inc — 159 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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