Individual provider Active NPI

Evan J Kavanaugh, APRN

  • Nurse Practitioner
  • Topeka, KS
National Provider Identifier
1063167815
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-80991 Issued in KS
Practice address
2660 SW 3Rd St
Topeka, KS 66606-2442
Phone
(785) 354-9591
Fax
(785) 368-0739
NPI assigned
Feb 18, 2022
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-80991 KS Primary

Addresses

Primary practice location

2660 SW 3Rd St
Topeka, KS 66606-2442

Mailing address

1500 SW 10TH Ave
Topeka, KS 66604-1301
Phone (785) 354-9591

Other practice location 1

1500 SW 10th Ave
Topeka, KS 66604-1301
Phone (785) 354-5242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20220414001239 KS Practitioner - Nurse Practitioner 8224424429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 SW 10TH Ave
Stormont Vail Hospital
Topeka, KS 66604-1301
Phone (785) 354-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-80991KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Mar 28, 2022 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Mar 28, 2022 Accepting new patients

Locations

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

2660 SW 3rd St
Topeka, KS 66606
Phone (785) 270-8880

901 SW Garfield Ave
Topeka, KS 66606

Interoperability endpoints

  • Direct secure messaging: ekavanaugh12289@stormontvaildirect.org

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1063167815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SW 10TH AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666041301",
            "telephone_number": "785-354-9591",
            "fax_number": "785-368-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 SW 3RD ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666062442",
            "telephone_number": "785-354-9591",
            "fax_number": "785-368-0739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 SW 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666041301",
            "country_code": "US",
            "telephone_number": "785-354-5242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "EVAN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-80991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.