Billy Royce Evans, P.A.
Individual provider Active NPI Physician Assistant · Welch, OK
NPI 1083779052 · NPPES record last updated Oct 25, 2010
Key facts
- NPI
- 1083779052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA170 (OK)
- Practice address
- 343 South Commercial Street
Welch, OK 74369-0000 - Phone
- (918) 788-3918
- Fax
- (918) 788-3914
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100226000074 | OK | Practitioner - Physician Assistant | 6709921992 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170 | OK | MD | Audiologist |
| PA170 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Oklahoma Clinical Partners, Inc. | Past | Accepting new patients |
Interoperability endpoints
- provider8@chcneo.directbygreenway.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA170 | OK | Yes |
Addresses
Primary practice location
343 South Commercial Street
Welch, OK 74369-0000
Mailing address
343 South Commercial Street
Welch, OK 74369-0000
Phone (918) 788-3918
Other providers in Welch, OK
All providers in Welch, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.