Phelps Family Practice, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PHELPS FAMILY PRACTICE, PLLC

Practice address

204 Smith Ave
Shallotte, NC 28470-4458

Phone

(910) 842-2443

NPI assigned

Jun 25, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Bardin Phelps, F.N.P.

Title

Owner

Phone

(910) 842-2443

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1285830414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1369",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284591369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 SMITH AVE",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704458",
            "telephone_number": "910-842-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHELPS FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "BARDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-842-2443",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "F.N.P."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPROVAL NUMBER,BOM",
            "identifier": "201344",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Mary Palecek, LCSWA
• Kari Papagikos
• Adrienne Park
• Jennifer Louise Percival
• Peter Grumbos DDS Shallotte PLLC
• Danny C Phipps, DOCTOR OF MINISTRY
• Frank R Pinto, P.T.
• Robert Todd Pitts, NP
• Precision Audiology PLLC
• Kevin David Price, DO

• Family Nurse Practitioner in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.