Russell T. Phelps, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

303334 Issued in LA

Practice address

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902

Phone

(337) 521-9100

Fax

(337) 470-2019

NPI assigned

Sep 23, 2005

Last updated

May 3, 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 2

Addresses

Other identifiers 2

Other names 1

• R. Tom Phelps Other name

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of North Texas HSC, College of Osteopathic Med, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obhg Louisiana LLCGroup PAC ID 9234443250, 20 clinicians

Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Lourdes Physician Group LLC

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1437405883
  Medicare reassignment Care Compare group NPD
• Obhg Louisiana, LLC

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1639567316

  LA

  Medicare reassignment Care Compare group NPD
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  NPD (past)
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)

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

• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1356337422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-521-9100",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086902",
            "telephone_number": "337-521-9100",
            "fax_number": "337-470-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "RUSSELL",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K8421",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "303334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481122",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102762501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "PHELPS",
            "middle_name": "TOM",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Pham
• Mailynn H. Pham, O.D.
• Nancy Ann Pham, PHARM D
• Melanie Pharr, LPC
• Yolanda Phearse
• Philip Gachassin MD Apmc
• Philip S. Perret, M.D., Apmc
• Cordel Phillip
• Amanda Ruth Phillips, MD
• Evan Phillips, PA

• Obstetrics & Gynecology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.