Kevin Edward Phelps, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202219021 Issued in VA

Practice address

2775 Godwin Blvd
Suffolk, VA 23434-8037

Phone

(757) 539-0069

NPI assigned

Nov 17, 2020

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Virginia CVS Pharmacy, L.L.C.

  dba CVS Pharmacy #11056

  • Pharmacy
  • Suffolk, VA
  • NPI 1043733785
  NPD (past)
• Virginia CVS Pharmacy, L.L.C.

  dba Cvs Pharmacy #17937

  • Pharmacy
  • Sterling, VA
  • NPI 1689558371
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1376146092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LOXLEY RD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237021809",
            "telephone_number": "757-675-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348037",
            "telephone_number": "757-539-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202219021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Persons Orthopaedic Sports Medicine and Joint Replacement Center, PC
• Jeffrey B Persons, M.D.
• Mariah Antionette Petite
• Cora Petrino
• Nickolas L. Pezzella, M.D.
• Philip R Thomas MD., LTD
• Alicia Philippou
• Physcial Therapy Works, Inc.
• Physical Therapy Works, Inc.
• Physical Therapy Works, Inc. (Physical Therapy Works)

• Pharmacist in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.