Individual provider Active NPI

Karen Sue Phelps, M.D.

  • Family Medicine Physician
  • Fort Eisenhower, GA
National Provider Identifier
1669532339
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036432 Issued in GA
Practice address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone
(706) 787-2720
Fax
(706) 787-8176
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036432 GA Primary

Addresses

Primary practice location

300 W Hospital Rd
Fort Eisenhower, GA 30905-5741

Mailing address

300 W Hospital Road
Eisenhower Army Medical Center Attn Credentials
Ft Gordon, GA 30905-5650
Phone (706) 787-2720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151102001890 GA Order and Referring Only - Family PracticePractitioner - Family Practice 8426245366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036432GAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1669532339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER ATTN CREDENTIALS",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2720",
            "fax_number": "706-787-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-2720",
            "fax_number": "706-787-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "036432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eisenhower, GA

Sources for this page

Verify at the official NPI Registry.