Individual provider Active NPI

David Lee Evers, ANP-BC

  • Adult Health Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1003182585
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2011011328 Issued in IN
Practice address
122 Wyoming St
Dayton, OH 45409-2731
Phone
(937) 223-4461
Fax
(937) 449-7603
NPI assigned
Mar 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2011011328 IN Primary

Addresses

Primary practice location

122 Wyoming St
Dayton, OH 45409-2731

Mailing address

122 Wyoming St
Dayton, OH 45409-2731
Phone (937) 223-4461

Other identifiers 1

IdentifierTypeStateIssuer
0149843MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208001641 OH Practitioner - Nurse Practitioner 3375799448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

122 Wyoming St
Dayton, OH 45409-2731
Phone (937) 438-8640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2011011328INMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Nov 16, 2015 Accepting new patients
Premier Health Specialists Inc CurrentSince Nov 16, 2015 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

122 Wyoming St
Dayton, OH 45409
Phone (937) 438-8640

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3006 N Dixie Hwy
Ste 104
Troy, OH 45373
Phone (937) 335-3518

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1003182585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092731",
            "telephone_number": "937-223-4461",
            "fax_number": "937-449-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092731",
            "telephone_number": "937-223-4461",
            "fax_number": "937-449-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERS",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "2011011328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149843",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.