Jennifer Mary Phelan, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1042-A Issued in SD

Practice address

414 E Clark St
Vermillion, SD 57069-2307

Phone

(605) 677-5474

NPI assigned

Jan 13, 2015

Last updated

Jul 17, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of South Dakota

  dba SD Human Services Center

  • Psychiatric Hospital
  • Yankton, SD
  • NPI 1124027586
  Medicare reassignment NPD
• State of South Dakota

  dba USD Speech & Hearing Clinic

  • Audiologist
  • Vermillion, SD
  • NPI 1346366044
  NPD

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1770972887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E CLARK ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570692307",
            "telephone_number": "605-677-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E CLARK ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570692307",
            "telephone_number": "605-677-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "JENNIFER",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001536",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SD",
            "license": "1042-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Christine Parker, RD
• Theresa Ann Person, M.D.
• Brandon I Peterson, DPT
• Kathryn Peterson, PA-C
• Taylor Kelsey Pfrommer, OTR
• Levi B Pole, DPT
• Rachel Post, PH.D
• Progression Psychological & Behavioral Health Group
• Gary Prosser, DDS
• Psychological Services of Vermillion, LLC

• Audiologist in Vermillion, SD
• Providers in Vermillion, SD by specialty
• Audiologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.