Micki Jade Evans

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A60432457 Issued in VA

Practice address

1501 Lakeside Dr
Lynchburg, VA 24501-3113

Phone

(434) 544-8100

NPI assigned

Aug 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1408147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408147200000",
    "number": "1073912937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 TRENTS FERRY RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245031117",
            "telephone_number": "434-544-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LAKESIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245013113",
            "telephone_number": "434-544-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MICKI",
        "middle_name": "JADE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-16",
        "last_updated": "2014-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "A60432457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ida Evans, MS, ATC, CMT
• Erin Evans, LPC
• Jenna Evans, LPC
• John Daniel Evans, PA-C
• Magda Evans, LPC
• Tabitha Marie Evans, RBT
• Thomas D Evans Jr., R.PH.
• Tia Latrese Evans
• Gregory William Evers Jr., D.O.
• Evidence Based Classroom Solutions

• Athletic Trainer in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2014; 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.