Nathaniel M Phelan, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2018014111 Issued in MO

Practice address

520 E 32ND St
Joplin, MO 64804-3904

Phone

(417) 622-0293

Fax

(833) 275-1784

NPI assigned

Mar 29, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

University of Arkansas College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phelan Dermatology and AestheticsGroup PAC ID 9234538331, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Phelan Dermatology & Aesthetics

  • Dermatology Physician
  • Joplin, MO
  • NPI 1942881677
  Medicare reassignment Care Compare group NPD
• E Medical Group of Missouri No 1 LLC

  • Home Health Agency
  • Joplin, MO
  • NPI 1104578111
  NPD
• Premier Dermatology & Skin Renewal Center

  • Clinical & Laboratory Dermatological Immunology Physician
  • Bentonville, AR
  • NPI 1912912361

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1225327422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043904",
            "telephone_number": "417-622-0293",
            "fax_number": "833-275-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043904",
            "telephone_number": "417-622-0293",
            "fax_number": "833-275-1784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21088 US Business Highway 71, #7",
            "address_purpose": "LOCATION",
            "city": "Pineville",
            "state": "MO",
            "postal_code": "64856",
            "country_code": "US",
            "telephone_number": "417-622-0293",
            "fax_number": "833-275-1784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "NATHANIEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "2018014111",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MO",
            "license": "2018014111",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2018014111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DERMATOLOGY",
            "identifier": "2018014111",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@phelandermatology.com",
            "affiliation": "N",
            "address_1": "21088 US Business Highway 71, #7",
            "city": "Pineville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "64856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@phelandermatology.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "520 E 32nd St",
            "city": "Joplin",
            "state": "MO",
            "country_code": "US",
            "postal_code": "648043904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• CHI Pham
• Hao Pham
• Tommy Phan, OTR/L
• Pharm Joplin Acquisition, LLC
• Phelan Dermatology & Aesthetics
• Shane Allan Philliber, CNP
• Andrea Dana Lee Phillips, LPC
• John Phillips, DO
• Kirsten Anne Phillips
• Michael Phillips, DO

• Dermatology Physician in Joplin, MO
• Providers in Joplin, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.