Jayson B. Phelps, DPM

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

Sex

Male

Sole proprietor

Yes

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.

• Loganville Foot and Ankle Medicine LLC

  • Foot & Ankle Surgery Podiatrist
  • Loganville, GA
  • NPI 1588821318

  GA

  Medicare reassignment NPD Authorized official
• Infinity Foot and Ankle Inc

  • Podiatric Clinic/Center
  • Loganville, GA
  • NPI 1063203644

  GA

  Medicare reassignment NPD
• Anniston Medical Clinic PC

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1619080017

  AL

  Medicare reassignment NPD
• Loganville Foot and Ankle

  • Podiatrist
  • Loganville, GA
  • NPI 1285001933
  NPD (past) Authorized official
• Allied Ankle & Footcare Centers PC

  • Foot & Ankle Surgery Podiatrist
  • Riverdale, GA
  • NPI 1437324498
  NPD (past)
• Georgia Foot & Ankle, P.C.

  • Podiatrist
  • Covington, GA
  • NPI 1174727119
  NPD (past)
• Georgia Foot & Ankle, P.C.

  • Podiatrist
  • Madison, GA
  • NPI 1376718148
  NPD (past)
• Village Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Covington, GA
  • NPI 1942036314

  Podiatrist

  NPD (past)
• Village Podiatry Group, L.L.C.

  • Podiatrist
  • Roswell, GA
  • NPI 1508846718
  NPD (past)

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

• Eastside Medical Center, LLC

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132

  Hospital

  Care Compare affiliation

Specialty

Podiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Procedures performed for Medicare patients

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 2, 2019.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "581994261",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "829746724O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10042144",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7595720",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322061",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "2701740",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "829746724A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "829746724B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82974624A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tammy Petty, P.T.
• Nicolas Thong Pham, MD
• Physiotherapy Associates Inc
• Piedmont Healthcare Encompass Health Eastside Rehab Hospital, LLC
• Kenneth Pierce, CADC II
• Amanda G Pilz, MPT
• Latifa J Pinnock, LCSW

• All providers in Loganville, GA
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.