Samuel Adam Phelps, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2957 Issued in TN

Practice address

138 S Washington Ave
Henderson, TN 38340-2323

Phone

(731) 989-3511

NPI assigned

Jul 14, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skyline Eye Clinic, PCGroup PAC ID 0042253882, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.16 of 100Reported as group

Quality

97.83

Improvement activities

40

Cost

76.76

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sphelps@ecpc.intellechartdirect.net
• FHIR API: https://api.platform.athenahealth.com/14790/brand/1/csg/1/fhir/r4

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.

• Skyline Eye Clinic, PC

  • Ophthalmology Physician
  • Jackson, TN
  • NPI 1154328813
  Medicare reassignment Care Compare group NPD
• Advanced Cardiovascular & Vein Center

  • Specialist
  • Jackson, TN
  • NPI 1164759189
  NPD
• Carol P. Lagrange, O.D., P.C.

  • Optometrist
  • Jackson, TN
  • NPI 1972520807
  NPD
• Paris Eye Care, LLC

  • Optometrist
  • Paris, TN
  • NPI 1780626168
  NPD (past)
• Professional Eyecare Associates and Optical PLLC

  • Optometrist
  • Humboldt, TN
  • NPI 1386821981
  NPD (past)

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1164651998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013951",
            "telephone_number": "731-424-2414"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "668 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013951",
            "country_code": "US",
            "telephone_number": "731-424-2414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1340 Union University Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383053780",
            "country_code": "US",
            "telephone_number": "731-424-2414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "SAMUEL",
        "middle_name": "ADAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001863",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neighborhood Network, Inc.
• Gabrielle Rose Nevels, MSW, LSSW
• Andrea Leigh Newman, BSSW
• Scott Sampson Norris
• Phelps Eye Care, PLLC
• Sarah Renee Pierce, AGACNP-BC, CCRN
• Lenita W. Powers, R.N.
• Benjamin Reese, PA-C
• Jessica Leigh Reese, WHNP-BC
• Charles Edward Rickard Jr., MSN,APRN,BC

• Optometrist in Henderson, TN
• Providers in Henderson, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.