Richard E Phelan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2318 Issued in AR

Practice address

1112 Military Rd
Benton, AR 72015-2909

Phone

(501) 778-7129

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

Yes

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

Merit-based Incentive Payment System (MIPS)

Final score

89.18 of 100Reported as group

Quality

90.37

Promoting interoperability

100

Improvement activities

40

Cost

73.56

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841371549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152909",
            "telephone_number": "501-778-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152909",
            "telephone_number": "501-778-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annicia Patrice Pettus, MS, RD, LD
• Jamie Keith Pettus, LPN
• Melissa Pettus
• Ann Pevahouse, DDS
• Pharmacy Care of Benton, LLC
• Skyler Phelps, M.S., CCC-SLP
• Tanya Phelps, RECOVERY ASSISTANT
• Gwan Phifer, RECOVERY ASSISTANT
• Phillip Suffridge,M.D.,P.a.
• Kalen Phillips

• General Practice Dentistry in Benton, AR
• Providers in Benton, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.