NPI age
18 years
Enumerated 2007-08-01
● Active
Type 1 · Individual
Kelly Shadman Phillips, PA-C
Phillips is 1 of 86 physician assistant providers in Cumming and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 4 subspecialties
Licensed in
GA, NC, TN
3 states
Status
Active
No deactivations on record
Last NPPES update
2020-06-02
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
18 years
↑ 10 yr above median (8 yr)
State licenses
3 states
Top 90% — 9% of peers are multi-state
Subspecialties
2
In the 24% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-08Enumerated in NPPES
2007
2026
Where they practice
Practice location
1505 Northside Forsyth Blvd, Ste 3500
Cumming, GA 30041
Mailing address
3400 Old Milton Pkwy # C, Suite 290
Alpharetta, GA 300053707
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
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Physician AssistantDefinition to come...
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Physician AssistantDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003144287F | |
| 05 (GA) | 003144287H | |
| 05 (GA) | 003144287E |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
Recently enumerated nearby: 5 new physician assistant providers have been added in Cumming in the last 180 days.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.