NPIMap

Individual provider Active NPI

Shean Eric Phelps, M.D.

  • Family Medicine Physician
  • Enterprise, AL
National Provider Identifier
1972575777
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.28477 Issued in AL
Practice address
2 Cottage Ave
Enterprise, AL 36330-8552
Phone
(706) 315-8742
Fax
(334) 255-6959
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 045109 GA
Aerospace Medicine Physician 2083A0100X 045109 GA
Family Medicine Physician 207Q00000X MD.28477 AL Primary

Addresses

Primary practice location

2 Cottage Ave
Enterprise, AL 36330-8552

Mailing address

2 Cottage Ave
Enterprise, AL 36330-8552
Phone (706) 315-8742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.28477ALMDFamily Medicine Physician
045109GAMDAerospace Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andalusia Emergency Physicians, LLC Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients
Clanton Emergency Physicians, LLC Past Accepting new patients
Dennis R Thomas MD PC Family Medicine Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1972575777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COTTAGE AVE",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363308552",
            "telephone_number": "706-315-8742",
            "fax_number": "334-255-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COTTAGE AVE",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363308552",
            "telephone_number": "706-315-8742",
            "fax_number": "334-255-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "SHEAN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "045109",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "GA",
            "license": "045109",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.28477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.