Mary Edith Phelps, PTA
Physical Therapy Assistant in Belleville, IL. Individual provider (NPI-1).
NPI number1689415002
StatusActive
Last updated in NPPESJun 3, 2024
Details
- NPI
- 1689415002
- Entity type
- Individual (NPI-1)
- Name
- Mary Edith Phelps
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2024
- Certification date
- Jun 2, 2024
- Last updated
- Jun 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 160001392 | IL | Yes |
Practice location
605 N 27th StBelleville, IL 62226-6509
Phone 618-531-4648
Mailing address
605 N 27th StBelleville, IL 62226-6509
Phone 618-531-4648
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapy Assistant providers in Belleville, IL
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- Khamryn Jeanette HendricksNPI 1033801121
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- Jayne E. Ninness, LPTANPI 1396168332
All 15 Physical Therapy Assistant providers in Belleville · All 1,953 providers in Belleville
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