Individual provider Active NPI

Evan Charles Delancey, DO

  • Obstetrics & Gynecology Physician
  • Jonesboro, AR
National Provider Identifier
1043892581
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E-20515 Issued in AR
Practice address
4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone
(870) 936-8000
Fax
(870) 934-3631
NPI assigned
Apr 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X E-20515 AR Primary
Obstetrics & Gynecology Physician 207V00000X 621854358 TN

Addresses

Primary practice location

4802 E Johnson Ave
Jonesboro, AR 72405-8413

Mailing address

PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260610003236 AR Practitioner - Obstetrics/Gynecology 7416336086

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Arkansas Clinic Charitable Foundation, Inc.Group PAC ID 2961547526, shared by 4 NPIs, 294 clinicians

Practice addresses (Care Compare)

4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-20515ARMDObstetrics & Gynecology Physician
621854358TNMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1043892581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724058413",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANCEY",
        "first_name": "EVAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E-20515",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "621854358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.