Tricia Lee Phelps

Primary specialty

OpticianTaxonomy code 156FX1800X

Practice address

639 W 275 S
Blackfoot, ID 83221-6332

Phone

(208) 681-6177

NPI assigned

Jun 12, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1437833449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 W 275 S",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832216332",
            "telephone_number": "208-681-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 W 275 S",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832216332",
            "telephone_number": "208-681-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "TRICIA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Pedigo, LPC
• Peggy J Trebilcock DDS PC
• Darin Perry, LMFT
• David Peters
• Jacob Matthew Pettit, DPT
• Jodi Munson Phillips, LSW
• Matthew Shawn Phillips, PHARMD
• Brandon K Pieper, CRNA
• Courtney Porter, PTA
• Delyn D Porter

• Optician in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Optician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.