Mary Selena Phaup

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

001050 Issued in KY

Practice address

1015 College Dr
Madisonville, KY 42431-9189

Phone

(270) 452-2188

Fax

(270) 245-2995

NPI assigned

Jul 30, 2007

Last updated

May 26, 2021By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Tennessee, HSC, College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phaup Physical Therapy, LLC

  • Physical Therapist
  • Madisonville, KY
  • NPI 1144775453
  Medicare reassignment NPD Authorized official
• Phaup Chiropractic Center, LLC

  • Clinic/Center
  • Madisonville, KY
  • NPI 1245747674
  NPD (past)

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1558551150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 COLLEGE DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319189",
            "telephone_number": "270-452-2188",
            "fax_number": "270-245-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 COLLEGE DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319189",
            "telephone_number": "270-452-2188",
            "fax_number": "270-245-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAUP",
        "first_name": "MARY",
        "middle_name": "SELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "001050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY STATE LICENSE",
            "identifier": "001050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Petroff, CRNA
• Russell E Peyton, NP
• Sarah Ruth Peyton, FNP
• Phaup Chiropractic Center, LLC
• Phaup Physical Therapy, LLC
• Candida Phelps
• Charles D Phelps, CRNA
• Susan Lynn Phelps, M.S.
• Nicole Pickerel
• Plastic Surgery Center, Inc (Plastic Surgery Center)

• Physical Therapist in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.