Jordan Micah Phelps, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS19877 Issued in FL

Practice address

14011 Beach Blvd Ste 120
Jacksonville, FL 32250-1695

Phone

(904) 223-6400

Fax

(833) 578-1820

NPI assigned

Mar 21, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Group Services PAGroup PAC ID 1254238579, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.phelps.1@25110.direct.athenahealth.com

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.

• Physicians Group Services PA

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1861440810
  Medicare reassignment Care Compare group NPD
• Physicians Group Services PA

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1497118160
  NPD
• Physicians Group Services PA

  • Durable Medical Equipment & Medical Supplies
  • Middleburg, FL
  • NPI 1699170035
  NPD
• PCP Financial Services LLC

  • Exclusive Provider Organization
  • Orange Park, FL
  • NPI 1134378078
  NPD (past)
• Physicians Group Services PA

  • Physical Medicine & Rehabilitation Physician
  • Orange Park, FL
  • NPI 1528371051

  Family Medicine

  NPD (past)

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

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1861952376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "904-282-6331",
            "fax_number": "904-619-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14011 BEACH BLVD STE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501695",
            "telephone_number": "904-223-6400",
            "fax_number": "833-578-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1147 NW 64th Ter",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326054218",
            "country_code": "US",
            "telephone_number": "352-333-5152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "JORDAN",
        "middle_name": "MICAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Michael Phelan, M.D.
• Juliette Ristaline Phelps Maxwell I, M.D.
• Angela Phelps
• Benjamin Matthew Phelps, MD
• Diana Marie Phelps, MD
• Julie Phelps
• Kenneth Richard Phelps, PA-C
• Laran Phelps, LMT
• Shericka Rose Phelps
• Phenomenal Healthcare, LLC

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.