Clarissa M Phelps, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39647 Issued in KY

Practice address

1180 Newfield Ave
Stamford, CT 06905-1409

Phone

(314) 888-5233

NPI assigned

Feb 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Clarissa D Moxley Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• My Catholic Doctor, P.L.L.C.

  • Pediatrics Physician
  • New Canaan, CT
  • NPI 1396201307

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1366416885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051409",
            "telephone_number": "314-888-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051409",
            "telephone_number": "314-888-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "CLARISSA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2023-03-20",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "39647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P002770084",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000546325",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "027299800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARISSA",
            "last_name": "MOXLEY",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marc D Peyser, D.C.
• Caroline Pham, MD
• Pharmacy Healthcare Solutions LTD
• Pharmagen Laboratories
• William J Phelan III, RRT
• Steven Phelps
• Philip a Walker
• Lawrence Michael Philips
• Anthony E Phillips, LCSW
• Sonji Phillips, PHD

• Family Medicine Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.