Chandra Ruth Phelps, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

80718 Issued in NE

Practice address

616 13TH St Ste 110
Aurora, NE 68818-2426

Phone

(402) 631-7267

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

No

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.

• Sozo Family Services

  • Mental Health Counselor
  • Aurora, NE
  • NPI 1811362726
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2020.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1467067264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 13TH ST STE 110",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688182426",
            "telephone_number": "402-631-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 13TH ST STE 110",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688182426",
            "telephone_number": "402-631-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "CHANDRA",
        "middle_name": "RUTH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "80718",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NE",
            "license": "80718",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "NE",
            "license": "80718",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NE",
            "license": "80718",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "NE",
            "license": "80718",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "80718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Mertlik, PA
• Dorothy Ruth Molczyk, LMHP PLADC
• Jimmie L Morris, RP
• Jeffrey John Muilenburg, M.D.
• Tiffanie Kae Oswald, LPN
• Leah Pohlmeier
• Whitney Polen, APRN, FNP-C
• Azure Marie Pospisil
• Melissa Dawn Prentice, MS LMHP
• Quality Care Solutions, L.L.C.

• All providers in Aurora, NE
• Registered Nurse in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.