Active NPI
Michelle Phebus, ATC
- Other Specialist/Technologist
- Severn, MD
National Provider Identifier
1104362839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- A0000632
- Practice address
- 1812 Lorgnette CT
Severn, MD 21144-1635 - Phone
- (443) 844-6696
- NPI assigned
- Jan 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | A0000632 | MD | Primary |
Addresses
Primary practice location
1812 Lorgnette CT
Severn, MD 21144-1635
Mailing address
1812 Lorgnette CT
Severn, MD 21144-1635
Phone (443) 844-6696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0000632 | MD | MD | Other Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1104362839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 LORGNETTE CT",
"city": "SEVERN",
"state": "MD",
"postal_code": "211441635",
"telephone_number": "443-844-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 LORGNETTE CT",
"city": "SEVERN",
"state": "MD",
"postal_code": "211441635",
"telephone_number": "443-844-6696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHEBUS",
"first_name": "MICHELLE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-19",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "MD",
"license": "A0000632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severn, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.