Individual provider Active NPI

Carla M Evans, FNP

  • Nurse Practitioner
  • Williamsburg, VA
National Provider Identifier
1073869210
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN00047 Issued in RI
Practice address
1601 Commonwealth Ave
Williamsburg, VA 23185-5125
Phone
(757) 259-9466
NPI assigned
Jul 25, 2012
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CAPRN00047 RI
Family Nurse Practitioner 363LF0000X F0411035 VA
Registered Nurse 163W00000X 0001107154 VA
Registered Nurse 163W00000X RN35540 RI
Family Nurse Practitioner 363LF0000X APRN00047 RI
Nurse Practitioner 363L00000X APRN00047 RI Primary

Addresses

Primary practice location

1601 Commonwealth Ave
Williamsburg, VA 23185-5125

Mailing address

11844 Rock Landing Dr Ste B
Newport News, VA 23606-4202
Phone (757) 873-0161

Other practice location 1

11844 Rock Landing Dr Ste B
Newport News, VA 23606-4202
Phone (757) 873-0161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20251120003069 VA Practitioner - Nurse Practitioner 8628213501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Dermatology Skin Cancer Surgery Center, IncGroup PAC ID 4486749223, 10 clinicians

Practice addresses (Care Compare)

11844 Rock Landing Dr
Suite B
Newport News, VA 23606-4202
Phone (757) 873-0161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN35540RIMDRegistered Nurse
0001107154VAMDRegistered Nurse
CAPRN00047RIMDFamily Nurse Practitioner
F0411035VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Dermatology Skin Cancer Surgery Center, Inc CurrentSince Dec 1, 2025 Accepting new patients
Peninsula Dermatology Skin Cancer Surgery Center, Inc CurrentSince Nov 18, 2025 Accepting new patients

Locations

11844 Rock Landing Dr
Ste B
Newport News, VA 23606
Phone (757) 534-5050

1601 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 259-9466

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.

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1073869210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11844 ROCK LANDING DR STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064202",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 COMMONWEALTH AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855125",
            "telephone_number": "757-259-9466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11844 Rock Landing Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064202",
            "country_code": "US",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "CARLA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "CAPRN00047",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "F0411035",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001107154",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN35540",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN00047",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN00047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.