Active NPI
Tamika La Cher Phelps
- Prosthetics Case Management
- Clinton, MD
National Provider Identifier
1407359961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 111719
- Practice address
- 4615 Mary Beth Blvd
Clinton, MD 20735-9625 - Phone
- (301) 996-2656
- NPI assigned
- Mar 12, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 111719 | MD | Primary |
Addresses
Primary practice location
4615 Mary Beth Blvd
Clinton, MD 20735-9625
Mailing address
4615 Mary Beth Blvd
Clinton, MD 20735-9625
Phone (301) 996-2656
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111719 | MD | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520812800000",
"number": "1407359961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4615 MARY BETH BLVD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207359625",
"telephone_number": "301-996-2656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 MARY BETH BLVD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207359625",
"telephone_number": "301-996-2656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "TAMIKA",
"middle_name": "LA CHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-12",
"last_updated": "2018-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "MD",
"license": "111719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
- Marvin Peraza
- Hayda Torres Perdue, M.D
- Moriah Perry, ATC
- Person-Centered Home Care Services LLC
- Angelica Nicolina Ferrazzi Petrous, DNP, APRN, AGPCNP-BC
- Physician Imaging of Washington Hospital Center, LLC (MedStar Radiology Network at Southern Maryland)
- Ma Riza Pico, PT
- Wendell C. Pierson, M.D.
- Pineview Dialysis Clinic LLC
- Pineview Extended Care Centre, Inc. (FutureCare Pineview)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.