Juliette Ristaline Phelps Maxwell I, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35071084 Issued in OH

Practice address

1833 Boulevard
VA Outpatient Clinic
Jacksonville, FL 32206-4382

Phone

(740) 453-7725

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1346322427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 GATE PKWY W APT 1320",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164106",
            "telephone_number": "740-526-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 BOULEVARD",
            "address_2": "VA OUTPATIENT CLINIC",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064382",
            "telephone_number": "740-453-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS MAXWELL",
        "first_name": "JULIETTE",
        "middle_name": "RISTALINE",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35071084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0294051",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pharmakon LLC (Duval Pharmacy LTC)
• La Quenda Mosby Pharr
• Helen Louise Elizabeth Phelan
• Paula R. Phelan, A.P.R.N., C.N.M.
• Timothy Michael Phelan, M.D.
• Angela Phelps
• Benjamin Matthew Phelps, MD
• Diana Marie Phelps, MD
• Jordan Micah Phelps, DO
• Julie Phelps

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.