Chardonnay H Phelan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16555 Issued in TX

Practice address

10447 TX-151
San Antonio, TX 78251

Phone

(210) 616-5385

NPI assigned

Mar 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• South Texas Allergy & Asthma Medical Professionals PLLC

  • Allergy & Immunology Physician
  • San Antonio, TX
  • NPI 1689085854
  Medicare reassignment
• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1205538063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 LATROBE POST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405240",
            "telephone_number": "281-851-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10447 TX-151",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78251",
            "telephone_number": "210-616-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "CHARDONNAY",
        "middle_name": "H",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy A Pharo, LPC
• Pharos
• PHCC-Mystic Park Rehabilitation and Health Care Center, LLC (Mystic Park Rehabilitation and Healthcare Center)
• PHCC-Paramount Rehabilitation and Health Care Center San Antonio, LLC (Paramount Rehabilitation and Healthcare Center)
• PHD Med
• Brooke Phelon
• Christopher Ian Phelps, M.D.
• Cynthia G Phelps, OD
• Erica Lian Phelps
• Kylie Ann Phelps

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.