NPIMap

Individual provider Active NPI

Jennifer Walker Phelps, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Martinsville, VA
National Provider Identifier
1134798564
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024181461 Issued in VA
Practice address
1107A Brookdale St
Martinsville, VA 24112-4501
Phone
(276) 670-3300
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0001207898 VA
Family Nurse Practitioner 363LF0000X 0024181461 VA Primary

Addresses

Primary practice location

1107A Brookdale St
Martinsville, VA 24112-4501

Mailing address

213 S Jefferson St
Roanoke, VA 24011-1705

Other practice location 1

4944 Greensboro Rd
Ridgeway, VA 24148-3390
Phone (276) 956-2233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220505001478 VA Practitioner - Nurse Practitioner 0345637625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Giles Community HospitalGroup PAC ID 3678670221, 223 clinicians
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

1107 A Brookdale St
Martinsville, VA 24112-4501
Phone (276) 670-3300

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Roanoke, VA, CCN 497275
  • Carilion Home Care Franklin Home health agency, Rocky Mount, VA, CCN 497038
  • Carilion Giles Community Hospital Hospital, Pearisburg, VA, CCN 491302
  • Sovah Health Danville Hospital, Danville, VA, CCN 490075
  • Carilion Franklin Memorial Hospital Hospital, Rocky Mount, VA, CCN 490089
  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001207898VAMDFamily Nurse Practitioner
0024181461VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Martinsville Henry County Coalition for Health and Wellness CurrentSince Jan 15, 2022 Accepting new patients
Martinsville Henry County Coalition for Health and Wellness Current Accepting new patients
Carilion Giles Community Hospital CurrentSince Sep 23, 2024 Accepting new patients
Martinsville Henry County Coalition for Health and Wellness CurrentSince Jan 15, 2022 Accepting new patients
Carilion Giles Community Hospital CurrentSince Sep 23, 2024 Accepting new patients
Carilion Medical Center PastSince Jul 28, 2024 Accepting new patients

Locations

324 T B Stanley Hwy
Ste B
Bassett, VA 24055
Phone (276) 629-1076

1107A Brookdale St
Martinsville, VA 24112
Phone (276) 634-0379

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

4944 Greensboro Rd
Ridgeway, VA 24148
Phone (276) 638-0787

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Interoperability endpoints

  • Direct secure messaging: jphelps184913@direct.carilionclinic.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1134798564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107A BROOKDALE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241124501",
            "telephone_number": "276-670-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4944 Greensboro Rd",
            "address_purpose": "LOCATION",
            "city": "Ridgeway",
            "state": "VA",
            "postal_code": "241483390",
            "country_code": "US",
            "telephone_number": "276-956-2233",
            "fax_number": "276-956-1629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "JENNIFER",
        "middle_name": "WALKER",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0001207898",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024181461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.