Individual provider Active NPI

Angus P Phelts III, MD

  • Otolaryngology Physician
  • Columbus, GA
National Provider Identifier
1073582789
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
024060 Issued in GA
Practice address
2300 Manchester Expressway
Ste a-005
Columbus, GA 31904
Phone
(706) 324-7753
Fax
(706) 324-7756
NPI assigned
Mar 15, 2006
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 24060 GA
Otolaryngology Physician 207Y00000X 024060 GA Primary

Addresses

Primary practice location

2300 Manchester Expressway
Ste a-005
Columbus, GA 31904

Mailing address

PO Box 7546
Columbus, GA 31908-7546
Phone (706) 320-2773

Other identifiers 1

IdentifierTypeStateIssuer
000415863AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071002000145 GA Practitioner - Otolaryngology 0941395222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24060GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Physician Practices LLC Current Accepting new patients
St. Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
St Francis Physician Practices LLC Otolaryngology CurrentSince Jan 1, 2016 Accepting new patients
St Francis Physician Practices LLC Past Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste A005
Columbus, GA 31904
Phone (706) 243-4550

2300 Manchester Expy
Ste C003
Columbus, GA 31904
Phone (706) 324-7753

3726 Woodruff Rd
Columbus, GA 31904
Phone (706) 257-7680

Interoperability endpoints

  • Direct secure messaging: angus.phelts@sfhga.gadirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1073582789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7546",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319087546",
            "telephone_number": "706-320-2773",
            "fax_number": "706-596-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPRESSWAY",
            "address_2": "STE A-005",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-324-7753",
            "fax_number": "706-324-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELTS",
        "first_name": "ANGUS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "24060",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "024060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000415863A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.