Mary Beth Evans

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

001579 Issued in KY

Practice address

1169 Eastern Pkwy
Suite 2313
Louisville, KY 40217-1417

Phone

(502) 309-9800

Fax

(502) 309-9797

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1083766281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "SUITE 2313",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171417",
            "telephone_number": "502-309-9800",
            "fax_number": "502-309-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "001579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000964014",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87015798",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "001579",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION - LYMPHOLOGY ASSOCIATION OF NORTH AMERICA",
            "identifier": "002124",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joilynn Marie Evans, MD
• Kaley Elizabeth Evans
• Kendra Nicole Evans, APRN
• Kimberley Ann Evans, ARNP
• Kristina Marie Evans, LCSW
• Mary J Evans, CRNFA
• Meredith B Evans, MS, RD, LD
• Miles Steven Evans, M.D.
• Nathanial Evans, RPH, PHARMD
• Rachel Evans

• Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.