NPIMap

Individual provider Active NPI

Elizabeth Carrie Phelps, PA-C

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1073132817
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021000070 Issued in MO
Practice address
3231 S National Ave Ste 220
Springfield, MO 65807-7304
Phone
(417) 820-8450
NPI assigned
Apr 12, 2020
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2021000070 MO Primary

Addresses

Primary practice location

3231 S National Ave Ste 220
Springfield, MO 65807-7304

Mailing address

3231 S National Ave Ste 220
Springfield, MO 65807-7304
Phone (417) 820-8450

Other names 1

  • Elizabeth Carrie Collum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210129000993 MO Practitioner - Physician Assistant 1355755547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

3231 S National Ave
Springfield, MO 65807-7304

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2021000070MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Feb 22, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Feb 22, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Feb 22, 2021 Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3231 S National Ave
Ste 220
Springfield, MO 65807
Phone (417) 820-7450

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1073132817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 S NATIONAL AVE STE 220",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077304",
            "telephone_number": "417-820-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 S NATIONAL AVE STE 220",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077304",
            "telephone_number": "417-820-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ELIZABETH",
        "middle_name": "CARRIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-12",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021000070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "COLLUM",
            "middle_name": "CARRIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.