TIMOTHY MICHAEL PHELAN (NPI# 1639131584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639131584 |
| Entity Type | Individual |
| Full Name | TIMOTHY MICHAEL PHELAN |
| Credential | M.D. |
| Practice Address |
2525 Riverside Ave Jacksonville FL 32204-4710 |
| Mailing Address |
Po Box 25317 Tampa FL 33622-5317 |
| Practice Telephone | 9043880704 |
| Practice Fax Number | 9043879095 |
| Mailing Telephone | 8132860033 |
| Mailing Fax Number | 8132821806 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2019-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | ME28633 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 372361500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699050872 | Timothy R Phelan | Pharmacist | 131 N 26 St, Walgreens, Arkadelphia, AR 71923 | 2011-10-19 |
| 1760543375 | Timothy Edwin Phelan | Specialist | 1621 Creekside Dr, 102, Folsom, CA 95630-3493 | 2006-12-13 |
| 1134388473 | Timothy Patrick Phelan | Internal Medicine | 2940 N Mccord Rd, Toledo, OH 43615 | 2008-06-02 |
| Street Address |
2525 RIVERSIDE AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669449419 | Linda A Kramer | Nurse Practitioner | 2525 Riverside Ave, Jacksonville, FL 32204-4710 | 2006-03-01 |
| 1235574880 | Deirdre Marie Lahey | Obstetrics & Gynecology | 2525 Riverside Ave, Jacksonville, FL 32204-4710 | 2013-05-08 |
| 1265478556 | Naomi E. Rhodes | Advanced Practice Midwife | 2525 Riverside Ave, Jacksonville, FL 32204-4710 | 2006-06-22 |
| 1558303040 | Paula R. Phelan | Nurse Practitioner | 2525 Riverside Ave, Jacksonville, FL 32204-4710 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396108528 | Michelle Melanson | Obstetrics & Gynecology | 14546 Old Saint Augustine Rd Ste 305-311, Jacksonville, FL 32258-5468 | 2016-04-04 |
| 1316387947 | Alexander David Raw | Obstetrics & Gynecology | 1600 W Walnut St Bldg 3, Jacksonville, IL 62650-1136 | 2013-06-27 |
| 1912260613 | Paulami Guha | Obstetrics & Gynecology | 836 Prudential Dr Ste 1600, Jacksonville, FL 32207 | 2012-06-19 |
| 1689963696 | Dawn M Mormak | Obstetrics & Gynecology | 836 Prudential Dr Ste 1506, Jacksonville, FL 32207-8342 | 2011-03-30 |
| 1710210745 | Niamh A Condon | Obstetrics & Gynecology | 653-1 W 8th St # L-17, Jacksonville, FL 32209-6511 | 2009-09-09 |
| 1356531396 | Coastal Ob Gyn and Infertility | Obstetrics & Gynecology | 114a Memorial Dr, Jacksonville, NC 28546-6328 | 2007-07-26 |
| 1871614057 | Aida A. Malonzo | Obstetrics & Gynecology | 1512 Palm Ave, Jacksonville, FL 32207-2916 | 2007-04-03 |
| 1487717864 | Geoffrey Gillen | Obstetrics & Gynecology | 653 W 8th St # L17, Jacksonville, FL 32209-6511 | 2006-12-18 |
| 1306916580 | Jason R Thompson | Obstetrics & Gynecology | 6885 Belfort Oaks Place Ste 210, Jacksonville, FL 32216 | 2006-11-08 |
| 1154400554 | Charles Burk | Obstetrics & Gynecology | 203 Nacogdoches St Ste 210, Jacksonville, TX 75766-2455 | 2006-11-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.