NPIMap

Individual provider Active NPI

Janett K Phelps, DO

  • Family Medicine Physician
  • Clackamas, OR
National Provider Identifier
1164650255
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO158334 Issued in OR
Practice address
9775 SE Sunnyside Rd
Suite 200
Clackamas, OR 97015-5739
Phone
(503) 794-3830
Fax
(503) 794-3850
NPI assigned
Jun 26, 2009
Last updated
Feb 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO158334 OR Primary

Addresses

Primary practice location

9775 SE Sunnyside Rd
Suite 200
Clackamas, OR 97015-5739

Mailing address

2051 Kaen Rd
Suite 367
Oregon City, OR 97045-4035
Phone (503) 742-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180817000707 TX Practitioner - Family Practice 5890932883 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

502 E Goode St
Quitman, TX 75783-2539
Phone (903) 763-5402

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Dec 6, 2019 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Mar 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 6, 2019 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Mar 1, 2020 Accepting new patients
County of Clackamas Office of County Auditor Past Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients
Christus Trinity Clinic Texas Past Accepting new patients
Clackamas County Past Accepting new patients
Mother Frances Hospital Winnsboro Past Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

502 E Goode St
Ste 1E
Quitman, TX 75783
Phone (903) 763-5402

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

719 W Coke Rd
Ste 4
Winnsboro, TX 75494
Phone (903) 342-3760

Interoperability endpoints

  • Direct secure messaging: jphelps162649@christushealth.direct-ci.net

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1164650255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD",
            "address_2": "SUITE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-794-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD",
            "address_2": "SUITE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155739",
            "telephone_number": "503-794-3830",
            "fax_number": "503-794-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "JANETT",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO158334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.