Colton Jeffery Phelps, MSN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

58777 Issued in ID

Practice address

1675 Curlew Dr
Ammon, ID 83406-4718

Phone

(208) 523-5319

NPI assigned

Oct 15, 2024

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

4 Pillars of Success LLCGroup PAC ID 4688027188, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 4 Pillars of Success LLC

  dba Rehabilitative Health Services

  • Multi-Specialty Clinic/Center
  • Ammon, ID
  • NPI 1619134277

  Clinical

  Medicare reassignment Care Compare group NPD
• 4 Pillars of Success LLC

  dba Rehabilitative Health Services

  • Clinic/Center
  • Ammon, ID
  • NPI 1992487615

  Clinical

  NPD

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1316767205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2106",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064718",
            "telephone_number": "208-523-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "COLTON",
        "middle_name": "JEFFERY",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "58777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl Health Clinic
• Pearl Primary Care PLLC
• Jason L Peebles, LMSW
• Chrisanna Marie Peterson
• Amaya Pfannenstiel
• Scott Pickett, D.D.S.
• Madison Tena Pilster, BS
• Kolt Monte Piquet, PA-C
• Richard Stephen Piroschak, B.S. PHARMACY
• Benjamin Pixton, PMHNP

• Psychiatric/Mental Health Nurse Practitioner in Ammon, ID
• Providers in Ammon, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.