Rebecca Kathryn Phelps, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2009032690 Issued in MO

Practice address

28 Woodland Dr
Collinsville, IL 62234-1340

Phone

(618) 799-9805

NPI assigned

Jan 22, 2010

Sex

Female

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 MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• SSM Cardinal Glennon Childrens Hospital

  • Pediatrics Physician
  • O Fallon, IL
  • NPI 1174577670

  MO

  Medicare reassignment NPD
• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544
  Medicare reassignment NPD
• SSM Cardinal Glennon Children'S Hospital

  • Pediatrics Physician
  • Warrenton, MO
  • NPI 1962573212
  NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1881925337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WOODLAND DR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622341340",
            "telephone_number": "618-799-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WOODLAND DR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622341340",
            "telephone_number": "618-799-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "REBECCA",
        "middle_name": "KATHRYN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2009032690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dina Payne, MSW, LCSW
• PC Associates, LLC
• PC Associates, LLC
• Elizabeth Lynne Peel, MA, CCC-SLP
• Alyssa Kaylee Pellmann, PT, DPT
• Phillips Investments, LLC - Collinsville Operations Series
• James Phillips, MSW LSW
• Rachelle Irene Phillips, DMD
• Rylee Nicole Pickett
• Dallas Lee Pineda, DMD

• Pediatric Nurse Practitioner in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.