Active NPI
Evan Ann Cross, P.T.
- Geriatric Physical Therapist
- Indianapolis, IN
National Provider Identifier
1104089150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 05005040A
- Practice address
- 6077 Sunset LN
Indianapolis, IN 46228-1454 - Phone
- (317) 626-7432
- NPI assigned
- Jul 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 05005040A | IN | Primary |
Addresses
Primary practice location
6077 Sunset LN
Indianapolis, IN 46228-1454
Mailing address
6077 Sunset LN
Indianapolis, IN 46228-1454
Phone (317) 626-7432
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05005040A | IN | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430870400000",
"number": "1104089150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6077 SUNSET LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462281454",
"telephone_number": "317-626-7432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6077 SUNSET LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462281454",
"telephone_number": "317-626-7432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSS",
"first_name": "EVAN",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-09",
"last_updated": "2015-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IN",
"license": "05005040A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.