Individual provider Active NPI

Rob Phelps, R.PH.

  • Pharmacist
  • San Antonio, TX
National Provider Identifier
1306280136
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
34697 Issued in TX
Practice address
4319 Medical Dr
Suite 250
San Antonio, TX 78229-3381
Phone
(210) 615-7475
Fax
(210) 614-0804
NPI assigned
Apr 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 34697 TX Primary
Pharmacist 183500000X 36530 NY

Addresses

Primary practice location

4319 Medical Dr
Suite 250
San Antonio, TX 78229-3381

Mailing address

4319 Medical Dr
Suite 250
San Antonio, TX 78229-3381
Phone (210) 615-7475

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
36530NYMDPharmacist
34697TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1306280136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 MEDICAL DR",
            "address_2": "SUITE 250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293381",
            "telephone_number": "210-615-7475",
            "fax_number": "210-614-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 MEDICAL DR",
            "address_2": "SUITE 250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293381",
            "telephone_number": "210-615-7475",
            "fax_number": "210-614-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ROB",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "34697",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "36530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.