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1568772382

NPI Code Detail

MEDICARE: JARYN ROYCE PHELPS AUD

MEDICARE: JARYN ROYCE PHELPS AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	654BD01	NC
2	231H00000X	Audiologist	9065	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	774097	OTHER		WELLCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	30110579	OTHER	SC	SELECT HEALTH OF SC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	9119790	OTHER		AETNA
6	162CV	OTHER	NC	BCBSNC
7	4492644	OTHER	NC	CIGNA

General Provider Information

NPI Number	:	1568772382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARYN ROYCE PHELPS AUD

Provider Business Mailing Address
First Line	:	6635 EXECUTIVE CIR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-3811
Country	:	US
Telephone Number	:	304-677-6264
Fax Number	:

Provider Business Practice Location Address
First Line	:	6035 FAIRVIEW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3256
Country	:	US
Telephone Number	:	704-838-8493
Fax Number	:	704-838-8494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	06/03/2026

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Directions to “ JARYN ROYCE PHELPS AUD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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