Individual provider Active NPI

Jayson B. Phelps, DPM

  • Podiatrist
  • Loganville, GA
National Provider Identifier
1851362644
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001006 Issued in GA
Practice address
135 Lee Byrd Rd
Loganville, GA 30052-2310
Phone
(678) 639-4209
Fax
(678) 639-4210
NPI assigned
Jan 30, 2006
Last updated
Jan 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001006 GA Primary

Addresses

Primary practice location

135 Lee Byrd Rd
Loganville, GA 30052-2310

Mailing address

135 Lee Byrd Rd
Loganville, GA 30052-2310
Phone (678) 639-4209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050921000565 GA Practitioner - Podiatry 8628002417 Reassigns benefits to 2 organizations
I20230426003081 AL Practitioner - Podiatry 8628002417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

135 Lee Byrd Rd
Loganville, GA 30052-2310
Phone (678) 639-4209

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue37
Removal of skin lesions11
Removal of nail tissue1076
Removal or shaving of skin growth364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Foot and Ankle Inc CurrentSince May 28, 2025 Accepting new patients
Loganville Foot and Ankle Medicine LLC CurrentSince Aug 30, 2005 Accepting new patients
Anniston Medical Clinic PC CurrentSince Apr 17, 2023 Accepting new patients
Georgia Foot & Ankle, P.C. Podiatrist Past Accepting new patients
Loganville Foot and Ankle Podiatrist Past Accepting new patients
Georgia Foot & Ankle, P.C. Podiatrist Past Accepting new patients
Allied Ankle & Footcare Centers PC Past Accepting new patients
Village Podiatry Group, L.L.C. Podiatrist PastSince Jun 1, 2003 Accepting new patients
Village Podiatry Group LLC Podiatrist Past Accepting new patients

Locations

1010 Christine Ave
Anniston, AL 36207
Phone (256) 236-5631

135 Lee Byrd Rd
Loganville, GA 30052
Phone (302) 753-8294

3529 Highway 81
Loganville, GA 30052
Phone (678) 639-4209

Organizations & group practices 9

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 1

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1851362644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 LEE BYRD RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522310",
            "telephone_number": "678-639-4209",
            "fax_number": "678-639-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 LEE BYRD RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522310",
            "telephone_number": "678-639-4209",
            "fax_number": "678-639-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "JAYSON",
        "middle_name": "B.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

Verify at the official NPI Registry.