Christine Ann Phelps, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3700 Kolbe Rd
Lorain, OH 44053-1611

Phone

(440) 960-4522

Fax

(440) 960-4523

NPI assigned

Oct 23, 2006

Last updated

Nov 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

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.

• Martin Kernberg MD Inc

  dba Jefferson Pain Clinic

  • Interventional Pain Medicine Physician
  • Crescent City, CA
  • NPI 1780053033
  NPD (past)
• Sutter West Bay Medical Foundation

  dba Endoscopy Center of Santa Rosa

  • Ambulatory Surgical Clinic/Center
  • Santa Rosa, CA
  • NPI 1811242563
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1447333570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 MARSHALL ST",
            "address_2": "SUITE 18",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955312281",
            "telephone_number": "707-464-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4522",
            "fax_number": "440-960-4523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Marshall St",
            "address_2": "Suite 18",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955312281",
            "country_code": "US",
            "telephone_number": "707-464-1989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13857",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiquitta Petty
• Breyonna Faith Pfeiffer
• Huan Viet Pham, O.D.
• Pharmacy Counter LLC
• Phazes LLC
• Courtney M Phillips
• Edward Phillips
• Robin Phillips, LISW-S
• Rachel Pidala
• Trisha Pileski, RN

• Physician Assistant in Lorain, OH
• Providers in Lorain, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.