Active NPI
Haley Anne Phelps, PA-C
- Physician Assistant
- El Dorado Hills, CA
National Provider Identifier
1235594151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 52951
- Practice address
- 1200 Suncast LN Ste 5
El Dorado Hills, CA 95762-9664 - Phone
- (916) 939-3889
- NPI assigned
- Dec 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 52951 | CA | Primary |
Addresses
Primary practice location
1200 Suncast LN Ste 5
El Dorado Hills, CA 95762-9664
Mailing address
1200 Suncast LN Ste 5
El Dorado Hills, CA 95762-9664
Phone (916) 939-3889
Other practice location 1
1011 Saint Andrews Dr
Suite H
El Dorado Hills, CA 95762-4248
Phone (916) 939-3889
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52951 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584144000000",
"number": "1235594151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 SUNCAST LN STE 5",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629664",
"telephone_number": "916-939-3889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 SUNCAST LN STE 5",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629664",
"telephone_number": "916-939-3889"
}
],
"practiceLocations": [
{
"address_1": "1011 Saint Andrews Dr",
"address_2": "Suite H",
"address_purpose": "LOCATION",
"city": "El Dorado Hills",
"state": "CA",
"postal_code": "957624248",
"country_code": "US",
"telephone_number": "916-939-3889",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHELPS",
"first_name": "HALEY",
"middle_name": "ANNE",
"name_prefix": "Miss",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-18",
"last_updated": "2020-03-14",
"certification_date": "2020-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "52951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.