Individual provider Active NPI

Kevin Francis Omeara, M.D.

  • Emergency Medicine Physician
  • Evanston, WY
National Provider Identifier
1063529568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4267A Issued in WY
Practice address
190 Arrowhead Dr
Evanston, WY 82930-9266
Phone
(307) 679-8391
Fax
(307) 783-8299
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4267A WY Primary

Addresses

Primary practice location

190 Arrowhead Dr
Evanston, WY 82930-9266

Mailing address

190 Arrowhead Dr
Evanston, WY 82930-9266
Phone (307) 679-8391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061221000015 WY Practitioner - Emergency Medicine 6709885775 Reassigns benefits to 1 organization
I20141219001160 AL Practitioner - Emergency Medicine 6709885775 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nebraska College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies Alabama PLLCGroup PAC ID 5395105183, 23 clinicians

Practice addresses (Care Compare)

1613 N McKenzie St
Foley, AL 36535-2247
Phone (251) 949-3540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4267AWYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Emergency Group, LLC Emergency Medicine CurrentSince Dec 8, 2018 Accepting new patients
Ies Alabama PLLC Emergency Medicine CurrentSince Jun 28, 2023 Accepting new patients
Mobile Emergency Physicians, LLC Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
Evanston Emergency Physicians PLLC PastSince May 14, 2003 Accepting new patients

Locations

849 S Three Notch St
Andalusia, AL 36420
Phone (334) 222-6953

1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400

3590 Gulf Shores Pkwy
Gulf Shores, AL 36542
Phone (251) 215-4853

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

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.

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063529568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ARROWHEAD DR",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309266",
            "telephone_number": "307-679-8391",
            "fax_number": "307-783-8299"
        },
        {
            "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": "307-679-8391",
            "fax_number": "307-783-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMEARA",
        "first_name": "KEVIN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "4267A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

Verify at the official NPI Registry.