Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Khadijah Lynn Phelps

Individual provider Medical-Surgical Registered Nurse · NPI 1972496636

Khadijah Lynn Phelps is a Nurse Practitioner in Charlotte, North Carolina. Qualified in 2025, 1 year ago. Works from 7 locations. Licensed in South Carolina.

Years since qualifying
1
Licensed in
SC
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

10628 Park Rd
Charlotte, NC 28210-8407
Phone: (704) 667-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (6)

  • 1506 N Fant St, Anderson, SC 29621-4708 — (864) 260-6995
  • 7021 Saint Andrews Rd Ste 1, Columbia, SC 29212-1177 — (803) 791-7175
  • 127 Ben Casey Dr Ste 103, Fort Mill, SC 29708-6600 — (502) 855-7200
  • 10 Enterprise Blvd Ste 201, Greenville, SC 29615-3554 — (864) 295-6399
  • 9404 Highway 78 Ste 100, Ladson, SC 29456-3909 — (502) 855-7200
  • 279 E Kennedy St, Spartanburg, SC 29302-1912 — (864) 583-0053

Specialties & licences

Medical-Surgical Registered Nurse (primary) Taxonomy 163WM0705X · Licence 261584 (SC)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 31864 (SC)

Record details

NPI number1972496636
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 2, 2025
Last updated in NPPESMay 7, 2026
Certification dateMay 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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