Kristin Lynn Phelps, PA-C
Individual provider Active NPI Physician Assistant · Grinnell, IA
NPI 1649433707 · NPPES record last updated Jul 29, 2009
Key facts
- NPI
- 1649433707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 001915 (IA)
- Practice address
- 210 4TH Ave
Grinnell, IA 50112-1898 - Phone
- (641) 236-2055
- Fax
- (641) 236-2907
- NPI assigned
- Jul 8, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grinnell Regional Medical Center
Practice addresses (Care Compare)
202 4TH Ave
FL 2
Grinnell, IA 50112-1898
Phone (641) 236-2925
210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-7511
Hospital & facility affiliations
- Grinnell Regional Medical Center
- St Francis Manor
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080728000364 | IA | Practitioner - Physician Assistant | 0143394932 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001915 | IA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grinnell Regional Medical Center | Physician Assistant | Current |
Accepting new patients |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Michael J Rosenfeld | Past | Accepting new patients |
Locations
210 4th Ave
Grinnell, IA 50112
Phone (641) 236-2055
210 4th Ave
Fl 3
Grinnell, IA 50112
Phone (641) 236-2905
Interoperability endpoints
- kristinphelps@grmc.allscriptsdirect.net
- kphelps672014@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001915 | IA | Yes |
Addresses
Primary practice location
210 4TH Ave
Grinnell, IA 50112-1898
Mailing address
210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-2055
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73096 | Other | IA | WELLMARK BCBS |
Other names
- Kristin Lynn Leonard
Other providers in Grinnell, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.