Shawn P Phelan, D.O.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2222 Issued in NC

Practice address

851 Wake Forest Business Park
Ste. E
Wake Forest, NC 27587-7366

Phone

(919) 562-0302

Fax

(919) 569-9560

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Wagoner Holdings PA

  dba Wake Forest Chiropractic

  • Health Service Clinic/Center
  • Wake Forest, NC
  • NPI 1679236400
  NPD

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1740275072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 WAKE FOREST BUSINESS PARK",
            "address_2": "STE. E",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877366",
            "telephone_number": "919-562-0302",
            "fax_number": "919-569-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 WAKE FOREST BUSINESS PARK",
            "address_2": "STE. E",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877366",
            "telephone_number": "919-562-0302",
            "fax_number": "919-569-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "SHAWN",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personalized Hematology-Oncology of Wake Forest PLLC
• Heather Louise Petersen, LCSW
• Julie Ann Peterson, M.A.,LPC
• Martin Tsvetanov Petkov
• Jeremy Phan, MS
• Stephanie Leeanne Phelps
• Philip D. Burton M.D. PLLC
• Gregory Phillips, DPM
• Margaret Faye Bergin Phillips, MA, CCC-SLP
• Phoenix and Oak Counseling

• Chiropractor in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.