NPIMap

Individual provider Active NPI

Craig Phelps, M.D.

  • Family Medicine Physician
  • Elk City, OK
National Provider Identifier
1295840288
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11010 Issued in OK
Practice address
1710 W 3Rd St
Suite 103B
Elk City, OK 73644-5159
Phone
(580) 225-8600
Fax
(580) 225-8603
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11010 OK Primary

Addresses

Primary practice location

1710 W 3Rd St
Suite 103B
Elk City, OK 73644-5159

Mailing address

PO Box 1047
Elk City, OK 73648-1047
Phone (580) 225-8600

Other identifiers 2

IdentifierTypeStateIssuer
100200430AMedicaidOK
P00343048OtherOKRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803001053 OK Practitioner - Family Practice 8921031832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1710 W 3Rd St
Suite 101
Elk City, OK 73644-5162
Phone (580) 225-8600

Hospital & facility affiliations

  • Shepherd Home Health & Hospice, LLC Home health agency, Clinton, OK, CCN 377702
  • Traditions Health of Elk City Hospice, Elk City, OK, CCN 371583
  • Traditions Health of Woodward Hospice, Woodward, OK, CCN 371669
  • Great Plains Regional Medical Center Hospital, Elk City, OK, CCN 370019
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Newman Memorial Hospital Hospital, Shattuck, OK, CCN 371336
  • Bell Avenue Nursing Center Nursing home, Elk City, OK, CCN 375399

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions25
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11010OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Oklahoma Wellness LLC PastSince Nov 12, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFDBDD/Endpoint/IFDBDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/IFDBDD

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1295840288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1047",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736481047",
            "telephone_number": "580-225-8600",
            "fax_number": "580-225-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W 3RD ST",
            "address_2": "SUITE 103B",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736445159",
            "telephone_number": "580-225-8600",
            "fax_number": "580-225-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "11010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200430A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00343048",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.