NPIMap

Individual provider Active NPI

Mittye Victoria Evans, ARNP

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1063446136
Registry record updated Sep 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1559512 Issued in FL
Practice address
14902 Winding Creek CT
Ste 105-C
Tampa, FL 33613-1640
Phone
(813) 908-5685
Fax
(813) 968-2526
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2011

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 1559512 FL Primary

Addresses

Primary practice location

14902 Winding Creek CT
Ste 105-C
Tampa, FL 33613-1640

Mailing address

14902 Winding Creek CT
Ste 105-C
Tampa, FL 33613-1640
Phone (813) 908-5685

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1559512FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ags Healthcare Specialists Inc Past Accepting new patients
Seniorelite LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315180800000",
    "number": "1063446136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14902 WINDING CREEK CT",
            "address_2": "STE 105-C",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131640",
            "telephone_number": "813-908-5685",
            "fax_number": "813-968-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14902 WINDING CREEK CT",
            "address_2": "STE 105-C",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131640",
            "telephone_number": "813-908-5685",
            "fax_number": "813-968-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MITTYE",
        "middle_name": "VICTORIA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "1559512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2011; 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.