Individual provider Active NPI

William J Phelan III, M.D.

  • Pediatrics Physician
  • Allentown, PA
National Provider Identifier
1104942416
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD023578E Issued in PA
Practice address
2200 W Hamilton St
Suite 214
Allentown, PA 18104-6337
Phone
(610) 770-9111
Fax
(610) 770-9507
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD023578E PA Primary

Addresses

Primary practice location

2200 W Hamilton St
Suite 214
Allentown, PA 18104-6337

Mailing address

2200 W Hamilton St
Suite 214
Allentown, PA 18104-6337
Phone (610) 770-9111

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD023578EPAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104942416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W HAMILTON ST",
            "address_2": "SUITE 214",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046337",
            "telephone_number": "610-770-9111",
            "fax_number": "610-770-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W HAMILTON ST",
            "address_2": "SUITE 214",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046337",
            "telephone_number": "610-770-9111",
            "fax_number": "610-770-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD023578E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.