NPIMap

Individual provider Active NPI

Erin O'Malley Phelps, P.A.-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1528481553
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04790 Issued in NC
Practice address
131 Miller St
Winston Salem, NC 27103-2508
Phone
(336) 716-8200
Fax
(336) 716-9841
NPI assigned
Jan 28, 2014
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04790 NC Primary
Medical Physician Assistant 363AM0700X 0010-04790 NC

Addresses

Primary practice location

131 Miller St
Winston Salem, NC 27103-2508

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074

Other identifiers 1

IdentifierTypeStateIssuer
1528481553MedicaidNC

Other names 1

  • Erin Aileen O'Malley Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eomalley160940@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140422002034 NC Practitioner - Physician Assistant 8224260484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1901 Mooney St
Winston Salem, NC 27103-3027
Phone (336) 716-8091

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-04790NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greensboro Radiology, PA Physician Assistant PastSince Oct 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ephelps3034251@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1528481553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MILLER ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032508",
            "telephone_number": "336-716-8200",
            "fax_number": "336-716-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ERIN",
        "middle_name": "O'MALLEY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04790",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-04790",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528481553",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eomalley160940@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1635 Nc Highway 66 S Ste 235",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272843855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "O'MALLEY",
            "middle_name": "AILEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.