Douglas Phelps, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61178665 Issued in WA

Practice address

4210 Pioneer Woods Dr Ste a
Lincoln, NE 68506-7561

Phone

(402) 488-4321

Fax

(402) 488-4355

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Doug Phelps Other name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment
• Urgent Care Clinic of Lincoln, PC

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1114341948
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Physical Therapist
  • Lakewood, WA
  • NPI 1790298081
  NPD
• Nebraska Orthopaedic Center PC

  • Orthopaedic Surgery Physician
  • Lincoln, NE
  • NPI 1659349330

  Medical

  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1447201389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67250",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067250",
            "telephone_number": "402-328-2907",
            "fax_number": "888-965-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 PIONEER WOODS DR STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067561",
            "telephone_number": "402-488-4321",
            "fax_number": "402-488-4355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Mercado St",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813017300",
            "country_code": "US",
            "telephone_number": "970-247-5362",
            "fax_number": "970-259-6045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "DOUGLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61178665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOUG",
            "last_name": "PHELPS",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Myhanh Thi Phan-Rinne, D.D.S.
• Lien Le Phan
• Pharmacy Solutions Inc
• Pharmscript of NE LLC
• Caitlin Phelps, LMHP
• Meredith Phelps
• Patrick Phelps
• Rebecca Ruth Phelps, M.S. CCC-SLP
• Beverly J Philippi, APRN, BC
• Andrea Phillips, PLMHP

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.