Organization Active NPI

Phelps Eye Care, PLLC

  • Optometrist
  • Henderson, TN
National Provider Identifier
1134567845
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PHELPS EYE CARE, PLLC
Practice address
138 S Washington Ave
Henderson, TN 38340-2323
Phone
(731) 989-3511
Fax
(731) 989-3515
NPI assigned
Jun 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Dr. Samuel Adam Phelps, O.D.
Title
Optometrist
Phone
(731) 514-8623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

138 S Washington Ave
Henderson, TN 38340-2323

Mailing address

138 S Washington Ave
Henderson, TN 38340-2323
Phone (731) 989-3511

National Provider Directory

National Provider Directory

Locations

168 Obed Plz
Ste 107
Crossville, TN 38555
Phone (931) 456-5155

138 S Washington Ave
Henderson, TN 38340
Phone (731) 989-3511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1134567845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S WASHINGTON AVE",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402323",
            "telephone_number": "731-989-3511",
            "fax_number": "731-989-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S WASHINGTON AVE",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402323",
            "telephone_number": "731-989-3511",
            "fax_number": "731-989-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHELPS EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "731-514-8623",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.