Evan Bevolden

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006478 Issued in MI

Practice address

1700 Clinton St
Muskegon, MI 49442-5502

Phone

(231) 728-4601

NPI assigned

Sep 20, 2012

Sex

Male

Sole proprietor

No

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment
• Lake Michigan Observation Services PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Muskegon, MI
  • NPI 1518626043
  Medicare reassignment

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1093066870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 SOUTHERN AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490014334",
            "telephone_number": "406-581-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CLINTON ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425502",
            "telephone_number": "231-728-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVOLDEN",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith L Best, PAC
• Joseph Alan Betcher, M.D.
• Katherine E Betcher, M.D.
• David Betlejewski, MBA
• Keesha Lawann Betts, CNA
• Beyond the Horizon LLC
• Almira K Bezinque, LLMSW
• Janay Biddle
• Samuel Biddle
• Barbara Bien, PA-C

• Medical Physician Assistant in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.