Mary Phelps, MS, CNS

Primary specialty

NutritionistTaxonomy code 133N00000X

License

NU10000021 Issued in DC

Practice address

1236 Pennsylvania Ave SE
Washington, DC 20003-2226

Phone

(609) 477-3050

NPI assigned

Jul 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Master of Science

State licenses

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1881247633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 N ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200192139",
            "telephone_number": "609-477-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032226",
            "telephone_number": "609-477-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "MARY",
        "credential": "MS, CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "DC",
            "license": "NU10000021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NUTRITION SPECIALIST",
            "identifier": "17448",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "NU10000021",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CHARM",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2909 N St SE",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200192139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alfred Lorenzo Phelps, P.A.-C
• Benjamin Ryan Phelps, MD, MPH, CTROPMED
• Carmen Elise Phelps, LCSW-C, LICSW
• Chearie Phelps
• Darice Phelps
• Robbin Phelps
• Asa Phichaphop, MD
• Lori Phifer McDowell, M.S.
• Lashawn Rena Phifer
• Philanthropist, LLC

• Nutritionist in Washington, DC
• Providers in Washington, DC by specialty
• Nutritionist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.