Active NPI
Kevin M Phelan, M.D.
- Surgery Physician
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD210001446
- Practice address
- 51 MDG, Unit 2060
Apo, AP 96278 - Phone
- (505) 784-8717
- NPI assigned
- Apr 16, 2012
- Last updated
- Jun 3, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD210001446 | DC | Primary |
| Surgery Physician | 208600000X | 125.062147 | IL |
Addresses
Primary practice location
51 MDG, Unit 2060
Apo, AP 96278
Mailing address
900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 677-6219
Other practice location 1
900 23rd St NW
Washington, DC 20037
Phone (202) 677-6219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD210001446 | DC | MD | Surgery Physician |
| 125.062147 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Specialists of Charlotte, P.a. | Surgery | Current | Accepting new patients |
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Surgery | Current | Accepting new patients |
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Surgery | Current | Accepting new patients |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients |
Locations
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255
14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650
7300 Carmel Executive Park Dr
Ste 200
Charlotte, NC 28226
Phone (704) 364-8100
10030 Gilead Rd
Ste 245
Huntersville, NC 28078
Phone (704) 895-9390
441 McAlister Rd
Ste 2100
Lincolnton, NC 28092
Phone (980) 212-6250
200 W Grover St
Shelby, NC 28150
Phone (704) 487-8591
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- kphelan1171516@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 10
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.
-
dba Atrium Health Levine Children's Gastroenterology
- Obstetrics & Gynecology Physician
- Charlotte, NC
- NPI 1275774333
-
dba Atrium Health Musculoskeletal Institute Orthopedics & Sports Medici
- Orthopaedic Surgery Physician
- Charlotte, NC
- NPI 1437607686
-
- Surgery Physician
- Charlotte, NC
- NPI 1073599734
-
dba Levine Cancer Institute
- Medical Oncology Physician
- Indian Land, SC
- NPI 1669738829
NC
-
dba Atrium Health Pulmonary University
- Surgical Critical Care Physician
- Charlotte, NC
- NPI 1699979732
-
dba Atrium Health Pharmacy Kenilworth
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1982710554
-
dba Atrium Health Diabetes Prevention
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
dba Atrium Health General Surgery
- Surgical Critical Care Physician
- Shelby, NC
- NPI 1821469735
Surgery
-
dba Atrium Health General Surgery Lincoln
- Surgery Physician
- Lincolnton, NC
- NPI 1699006858
-
dba Atrium Health Pineville Rehabilitation Hospital
- Rehabilitation Hospital Unit
- Charlotte, NC
- NPI 1962987131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654214400000",
"number": "1497012488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 23RD ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200372342",
"telephone_number": "202-677-6219",
"fax_number": "202-741-3219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "MIL",
"address_1": "51 MDG, UNIT 2060",
"city": "APO",
"state": "AP",
"postal_code": "96278",
"telephone_number": "505-784-8717"
}
],
"practiceLocations": [
{
"address_1": "900 23rd St NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "20037",
"country_code": "US",
"telephone_number": "202-677-6219",
"fax_number": "202-741-3219",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHELAN",
"first_name": "KEVIN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-16",
"last_updated": "2022-06-03",
"certification_date": "2022-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "DC",
"license": "MD210001446",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125.062147",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.