Brandon Lee Phelps

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

170217 Issued in OH

Practice address

8091 Back Bay CT Apt 2a
Dayton, OH 45458-1766

Phone

(513) 496-6968

NPI assigned

Jun 5, 2023

Last updated

Jun 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1063106839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8091 BACK BAY CT APT 2A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581766",
            "telephone_number": "151-359-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8091 BACK BAY CT APT 2A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581766",
            "telephone_number": "513-496-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "BRANDON",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "170217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pharma Medical LLC
• Pharmacy Operations Inc (The Medicine Shoppe)
• Pharmacy Operations, Inc (Medicine Shoppe)
• Laemthong X Phavixay, DPM
• Andrea Monique Phelps
• Robert Milton Phelps Jr.
• Ronald J Phelps Jr., AGACNP-BC
• Pheonix Transformation LLC
• Ayo Phifer
• Azia Acu' Phifer

• Licensed Practical Nurse in Dayton, OH
• Providers in Dayton, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.