Cynthia M Phelan, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01061246A Issued in IN

Practice address

1300 State St
Suite 2E
La Porte, IN 46350-3185

Phone

(219) 326-5700

Fax

(219) 326-8131

NPI assigned

Jul 26, 2006

Last updated

Aug 5, 2008By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• La Porte Hospital Company LLC

  dba Northwest Health-La Porte

  • Medicare Defined Swing Bed Hospital Unit
  • La Porte, IN
  • NPI 1104585652
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1609890672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1690",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463521690",
            "telephone_number": "219-326-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 STATE ST",
            "address_2": "SUITE 2E",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503185",
            "telephone_number": "219-326-5700",
            "fax_number": "219-326-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01061246A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM, BCBS",
            "identifier": "000000379262",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200284520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Ann Perra
• Ashley Nicole Pesa, LMHC
• Erika Pettis
• Jaron Lee Pettis
• Mark E Pettis, PTA
• Hannah Phillips
• Dawn Marie Picard, AAS, MT
• James C Pickford, MD
• Tina Marie Pierce, NP
• Krishna R Pillai, MD

• Obstetrics & Gynecology Physician in La Porte, IN
• Providers in La Porte, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.