NPIMap

Individual provider Active NPI

Angela Michelle Phelps, MD

  • Family Medicine Physician
  • Warrensburg, MO
National Provider Identifier
1881616282
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2001014668 Issued in MO
Practice address
407 E Russell Ave BLDG C
Warrensburg, MO 64093-1242
Phone
(660) 747-5114
Fax
(660) 747-5684
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2001014668 MO Primary

Addresses

Primary practice location

407 E Russell Ave BLDG C
Warrensburg, MO 64093-1242

Mailing address

407 E Russell Ave BLDG C
Warrensburg, MO 64093-1242
Phone (660) 747-5114

Other identifiers 2

IdentifierTypeStateIssuer
7664602OtherMOAETNA
11127872OtherMOCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050916000562 MO Practitioner - Family Practice 0143253534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

407 E Russell Ave
BLDG C
Warrensburg, MO 64093-1242
Phone (660) 747-5114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001014668MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Missouri Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Western Missouri Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Gray Chiropractic & Wellness Center LLC Past Accepting new patients
Western Missouri Medical Center Past Accepting new patients
Community Health Partners, LLP PastSince Oct 1, 2007 Accepting new patients

Locations

1200 W 22nd St
Higginsville, MO 64037
Phone (660) 262-7751

600 E Allen St
Ste A
Knob Noster, MO 65336
Phone (660) 563-5555

513 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 747-7751

403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500

407 E Russell Ave
#C
Warrensburg, MO 64093
Phone (660) 747-5114

Organizations & group practices 6

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 9

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881616282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E RUSSELL AVE BLDG C",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931242",
            "telephone_number": "660-747-5114",
            "fax_number": "660-747-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E RUSSELL AVE BLDG C",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931242",
            "telephone_number": "660-747-5114",
            "fax_number": "660-747-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001014668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7664602",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11127872",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, MO

Sources for this page

Verify at the official NPI Registry.