NPIMap

Organization Active NPI

Evanston Hospital Corporation

  • Certified Registered Nurse Anesthetist
  • Evanston, WY
National Provider Identifier
1013288836
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
EVANSTON HOSPITAL CORPORATION
Practice address
190 Arrowhead Dr
Evanston, WY 82930-9266
Phone
(307) 789-3636
Fax
(307) 783-8327
NPI assigned
Jan 25, 2012
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Laura J Fey
Title
Sr. Director Physician Rev Cycle
Phone
(615) 221-3641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

190 Arrowhead Dr
Evanston, WY 82930-9266

Mailing address

1573 Mallory LN Ste 100
Brentwood, TN 37027-2895
Phone (152) 221-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040609001235 WY Part B Supplier - Clinic/Group Practice 7113900358 Receives reassigned benefits from 27 practitioners
2 other NPIs on this enrollment
Practice locations: Evanston, WY; Lyman, WY
O20180823002979 NJ Part B Supplier - Clinic/Group Practice 7113900358 Receives reassigned benefits from 1 practitioner
Practice locations: East Brunswick, NJ

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bridger Valley Family P3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

465 Cranbury Rd
Ste 101
East Brunswick, NJ 08816
Phone (307) 783-8430

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1583/brand/2/csg/28/fhir/r4

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1013288836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 MALLORY LN STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272895",
            "telephone_number": "152-221-1400",
            "fax_number": "615-465-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ARROWHEAD DR",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309266",
            "telephone_number": "307-789-3636",
            "fax_number": "307-783-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSTON HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.