Booker Theodore Evans, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

AK4433 Issued in AZ

Practice address

225 Wendell St
Suite B
Fair Banks, AK 99701

Phone

(907) 455-4140

Fax

(907) 455-4119

NPI assigned

Jun 10, 2006

Last updated

Jan 14, 2008By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Beringia Mental Health LLC

  • Psychiatry Physician
  • Fairbanks, AK
  • NPI 1033308002
  Authorized official Same address or phone
• Presque Isle Psychiatric Associates

  • Psychiatry Physician
  • Erie, PA
  • NPI 1326242439
  NPD (past)
• St Aloisius Hospital Inc

  dba St Aloisius Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Harvey, ND
  • NPI 1639296007
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1093756736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WENDELL ST",
            "address_2": "SUITE B",
            "city": "FAIR BANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-455-4140",
            "fax_number": "907-455-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WENDELL ST",
            "address_2": "SUITE B",
            "city": "FAIR BANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-455-4140",
            "fax_number": "907-455-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BOOKER",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "AK4433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Miguel Estevez, MD
• Marie Doraine Estrada
• Evan L. Wheeler DDS,PC
• Andrew John Evanger, M.D.
• Iver Evanger
• Christina Evans
• Christina Lynn Evans
• Courtney Evans
• Courtney Evans, LMT
• David L Evans, MD

• Psychiatry Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Psychiatry Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.