DR. TIMOTHY EDWIN PHELAN (NPI# 1760543375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760543375 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY EDWIN PHELAN |
| Credential | M.D. |
| Practice Address |
1621 Creekside Dr 102 Folsom CA 95630-3493 |
| Practice Telephone | 9169847428 |
| Mailing Telephone | 9169847428 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | G084901 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL PROVIDER NUMBER | 00G849011 | 01 |
| CA | CA LICENSE NUMBER | G084901 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699050872 | Timothy R Phelan | Pharmacist | 131 N 26 St, Walgreens, Arkadelphia, AR 71923 | 2011-10-19 |
| 1134388473 | Timothy Patrick Phelan | Internal Medicine | 2940 N Mccord Rd, Toledo, OH 43615 | 2008-06-02 |
| 1639131584 | Timothy Michael Phelan | Obstetrics & Gynecology | 2525 Riverside Ave, Jacksonville, FL 32204-4710 | 2006-04-05 |
| Street Address |
1621 CREEKSIDE DR 102 |
| City | FOLSOM |
| State | CA |
| Zip Code | 95630-3493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659564730 | Timothy E Phelan, M.d A Professional Medical Corporation | Specialist | 1621 Creekside Dr, 102, Folsom, CA 95630-3493 | 2007-08-22 |
| 1164631776 | Bryan Randolph Dds A Professional Dental Corporation | Dentist | 1621 Creekside Dr, Suite 101, Folsom, CA 95630-3493 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1174153027 | Haley Harmon | Nurse Practitioner | 1621 Creekside Dr. Creekside Ob/gyn, Ste. 102, Folsom, CA 95630 | 2020-01-20 |
| 1932741469 | Ruma Ramani Jolly | Speech-Language Pathologist | 250 Mc Adoo Drive, Willow Springs, Apt.911, Folsom, CA 95630 | 2019-10-16 |
| 1750844767 | Sharon Munyaanyi | Registered Nurse | 1600 Creekside Dr Ste 3700, Folsom, CA 95630 | 2019-04-08 |
| 1104308345 | Stephanie Whatley | Optometrist | 2390 E Bidwell St Ste 400, Folsom, CA 95630 | 2018-09-04 |
| 1447746607 | Heather Michellee Thrapp | Behavioral Analyst | 125 Oak Ravine Way, Folsom, CA 95630 | 2018-07-10 |
| 1700370483 | Loretta May Delgado | Behavior Technician | 322 Crow Cany, Folsom, CA 95630 | 2018-06-18 |
| 1417448176 | Sound Support Inc. | Hearing Instrument Specialist | 610 East Bidwell Street, Suite A, Folsom, CA 95630 | 2018-05-29 |
| 1548750144 | Don Peterson Md, Sugical Assisting | General Practice | Mercy Hospital of Folsom (dignity Health Folsom), 1650 Creekside Dr., Folsom, CA 95630 | 2018-05-18 |
| 1245733328 | American Heritage Hospice Inc | Hospice Care, Community Based | 1837 Iron Point Rd Ste 180, Folsom, CA 95630 | 2018-03-14 |
| Find all providers in zip 95630 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992100671 | Heidi Jo Lockett | Specialist | 785 Orchard Dr Ste 120, Folsom, CA 95630-5558 | 2014-10-23 |
| 1427183003 | Sholeh --- Rahimi | Specialist | 1625 Creekside Dr 100, Folsom, CA 95630-3819 | 2007-02-22 |
| 1841376670 | Jose D Villarica I | Specialist | 834 Willow Creek Dr, Folsom, CA 95630-5246 | 2006-10-27 |
| 1457391773 | Kyung Kim | Specialist | 1631 Creekside Dr Ste 102, Folsom, CA 95630 | 2006-06-07 |
| 1164472759 | Hemlata Oswal | Specialist | 1650 Creekside Drive, Dept. of Pathology, Folsom, CA 95630-3400 | 2006-05-12 |
| 1124082474 | Jeffrey Richard Cragun | Specialist | 1735 Creekside Dr, Folsom, CA 95630-3914 | 2006-04-13 |
| 1801327598 | Folsom Urology Surgical Associates Inc | Specialist | 1600 Creekside Dr, Ste 3600, Folsom, CA 95630-3444 | 2017-03-23 |
| 1972971703 | Folsom Urgent Care Inc | Specialist | 1600 Creekside Dr, Suite 1400, Folsom, CA 95630-3444 | 2015-09-10 |
| 1982872255 | James C Yee Md Inc | Specialist | 1600 Creekside Dr, Suite 3400, Folsom, CA 95630-3444 | 2008-02-20 |
| 1578741401 | Gastroenterology Medical Clinic | Specialist | 1580 Creekside Dr Ste 220, Folsom, CA 95630-3888 | 2008-02-01 |
| Find all providers in FOLSOM | ||||
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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.