NPIMap

Individual provider Active NPI

Phyllis L Phelps, ARNP

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1770681595
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9232460 Issued in FL
Practice address
2315 W Jackson St
Pensacola, FL 32505-7552
Phone
(850) 436-4630
Fax
(850) 436-2095
NPI assigned
Sep 20, 2006
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9232460 FL Primary
Family Nurse Practitioner 363LF0000X CNP 4348 MN

Addresses

Primary practice location

2315 W Jackson St
Pensacola, FL 32505-7552

Mailing address

2315 W Jackson St
Pensacola, FL 32505-7552
Phone (850) 436-4630

Other identifiers 1

IdentifierTypeStateIssuer
307400500MedicaidFL

Other names 1

  • Phyllis Patten Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060227000411 FL Practitioner - Nurse Practitioner 6305735069 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Escambia Community Clinics IncGroup PAC ID 9638165806, shared by 15 NPIs, 36 clinicians

Practice addresses (Care Compare)

2315 W Jackson St
Pensacola, FL 32505-7552
Phone (850) 436-4630

6671 Caroline St
Milton, FL 32570-4781
Phone (850) 891-9433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9232460FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Escambia Community Clinics, Inc CurrentSince Dec 1, 2025 Accepting new patients
Primary Care House Calls PA Family CurrentSince Jul 1, 2022 Accepting new patients
Escambia Community Clinics Inc CurrentSince Dec 1, 2025 Accepting new patients
Anchor Health Centers PA Past Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients

Locations

2744 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 313-9046

5520 Stewart St
Milton, FL 32570
Phone (850) 891-9433

2315 W Jackson St
Pensacola, FL 32505
Phone (850) 495-3955

Interoperability endpoints

  • Direct secure messaging: phyllis.phelps.1@24790.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1770681595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W JACKSON ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325057552",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W JACKSON ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325057552",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "PHYLLIS",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9232460",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 4348",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307400500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHYLLIS",
            "last_name": "PATTEN",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.