KENNETH DEAN JR. PHILLIPS (MD) – Family Medicine Physician, NPI 1053383281
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,332 FAMILY PRACTICE in MO
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Provider Addresses for KENNETH DEAN JR. PHILLIPS (MD)
8, Doctors Park, Cape Girardeau, Cape Girardeau County, Missouri, 63703, United States
CAPE GIRARDEAU, MO 637034928
Phone: (573) 651-1333
Fax: (573) 651-1324
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 38 Open Payments records for all available years, with a total value of $678.
Total Amount is formed as General ($678) + Research ($0) + Ownership ($0) = $678.
Last reported payment date: 2024-10-08 • Largest payer in this snapshot: ABBVIE INC. ($473).
Total Amount
$678
General + Research + Ownership
Payments
38
Total payment records
General Amount
$678
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-08
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-12-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111230000389 | I | Family Practice | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 190 | 95 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 80 | 71 | $0 |
| 82947 | Blood glucose (sugar) level | 65 | 61 | $0 |
| 81002 | Urinalysis, manual test | 54 | 50 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 53 | 46 | $0 |
Insurance plans in this area (ZIP 63703)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | MO | |
| - | KS | |
| - | MO | |
| - | MO | |
| Nurse Practitioner | KS | |
| - | KS | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO |
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