Individual provider Active NPI

Jasmine A Evans, PT, DPT

  • Physical Therapist
  • Champaign, IL
National Provider Identifier
1013373588
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.021920 Issued in IL
Practice address
101 W University Ave
Champaign, IL 61820-3981
Phone
(217) 366-1323
NPI assigned
Jan 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.021920 IL Primary

Addresses

Primary practice location

101 W University Ave
Champaign, IL 61820-3981

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-1323

Other identifiers 1

IdentifierTypeStateIssuer
070.021920OtherILIL LISCENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jevans367665@CarleHieDirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.021920ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Mar 15, 2021 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Mar 15, 2021 Accepting new patients
Christie Clinic, PLLC Physical Therapist CurrentSince Feb 6, 2023 Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

2906 Crossing Ct
Champaign, IL 61822
Phone (217) 356-6543

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

5255 E Maryland St
Decatur, IL 62521
Phone (217) 864-1264

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

Interoperability endpoints

  • Direct secure messaging: jevans367665@carlehiedirect.net

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": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1013373588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JASMINE",
        "middle_name": "A",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.021920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LISCENSE",
            "identifier": "070.021920",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jevans367665@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 W University Ave",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618203981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.