Active NPI
Ryan Michael Phelps, PHARMD
- Pharmacist
- Chesterton, IN
National Provider Identifier
1578843223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26022420A
- Practice address
- 580 Indian Boundary Rd
Chesterton, IN 46304-1515 - Phone
- (219) 395-8583
- NPI assigned
- Aug 26, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26022420A | IN | Primary |
Addresses
Primary practice location
580 Indian Boundary Rd
Chesterton, IN 46304-1515
Mailing address
1668 Glasgow St
Valparaiso, IN 46385-7363
Phone (219) 242-8373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26022420A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1578843223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1668 GLASGOW ST",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463857363",
"telephone_number": "219-242-8373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 INDIAN BOUNDARY RD",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463041515",
"telephone_number": "219-395-8583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "RYAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-26",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26022420A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.