Taylor Shaun Phelps, MD

Primary specialty

Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X

License

309854 Issued in NY

Practice address

665 Duluth Hwy
Suite 401
Lawrenceville, GA 30046-3328

Phone

(678) 312-4077

NPI assigned

Mar 23, 2017

Last updated

Feb 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Ophthalmology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Louisiana State University School of Medicine in New Orleans Faculty GGroup PAC ID 0244136448, 445 clinicians

Lsuhn Billing LLCGroup PAC ID 0446337802, 203 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center New Orleans Hospital, New Orleans, LA, CCN 190005
• Touro Infirmary Hospital, New Orleans, LA, CCN 190046
• Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• LA PPO C-SNP

Interoperability endpoints

• Direct secure messaging: tphelps1631925@nychhc.direct-ci.com

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.

• Louisiana State University School of Medicine in New Orleans Faculty G

  dba LSU Healthcare Network

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1477582526
  Medicare reassignment Care Compare group NPD
• Lsuhn Billing LLC

  • Multi-Specialty Clinic/Center
  • Lafayette, LA
  • NPI 1992975775
  Medicare reassignment Care Compare group NPD
• Our Lady of the Angels Hospital, Inc.

  dba FMOL Health Our Lady of the Angels

  • General Acute Care Hospital
  • Bogalusa, LA
  • NPI 1912334533
  Medicare reassignment NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  dba Lsu Healthcare Network

  • Durable Medical Equipment & Medical Supplies
  • Kenner, LA
  • NPI 1316417629
  NPD
• Lsuhn Billing LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Baton Rouge, LA
  • NPI 1306247556
  NPD
• Wash-St Tammany Reg Medical Center

  dba Bogalusa Medical Center

  • General Acute Care Hospital
  • Bogalusa, LA
  • NPI 1508809088
  NPD

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

• Our Lady of the Lake Hospital Inc.

  dba Our Lady of the Lake Regional Medical Center

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1366436123
  Care Compare affiliation
• Touro Infirmary

  • Rehabilitation Hospital Unit
  • New Orleans, LA
  • NPI 1588817878
  Care Compare affiliation
• Touro Infirmary

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1821098286
  Care Compare affiliation
• University Medical Center Management Corporation

  dba University Medical Center New Orleans

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1568403111
  Care Compare affiliation

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1083145775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W 42ND ST APT 1527",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364371",
            "telephone_number": "478-919-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY",
            "address_2": "SUITE 401",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463328",
            "telephone_number": "678-312-4077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 Plaza St Rm 213",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273729",
            "country_code": "US",
            "telephone_number": "985-730-7209",
            "fax_number": "985-730-7195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "TAYLOR",
        "middle_name": "SHAUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "309854",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "333840",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "NY",
            "license": "309854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tphelps17127@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tphelps17127@direct.casso.us.com",
            "address_1": "433 Plaza St Rm 213",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704273729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "433 Plaza St Rm 213",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704273729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tu Oai Vu Pham, CSA
• Dalena Phan, LMSW
• Emmeleen F Phan, MD
• Donna Marie Pharis, ED.S,CCC-SLP
• Pharmacy Investments of Lawrenceville, LLC (RX Plus Pharmacy)
• Phemadex Healthcare Services Inc
• Ancy Philip, RN
• Sheena Philip
• Stacey Philip
• Caleb Phillips, RN

• Glaucoma Specialist (Ophthalmology) Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Glaucoma Specialist (Ophthalmology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.