Active NPI
Kaitlin Fay Evans, DO
- Pediatrics Physician
- Baton Rouge, LA
National Provider Identifier
1104455880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 322814
- Practice address
- 8415 Goodwood Blvd Ste 202
Baton Rouge, LA 70806-7851 - Phone
- (225) 765-8013
- Fax
- (225) 765-2033
- NPI assigned
- Apr 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 322814 | LA | Primary |
Addresses
Primary practice location
8415 Goodwood Blvd Ste 202
Baton Rouge, LA 70806-7851
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-8013
Other practice location 1
8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Phone (225) 374-4325
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250923003923 | MO | Order and Referring Only - Pediatric Medicine | 2365808649 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1104455880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 S SHERWOOD FOREST BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708166038",
"telephone_number": "225-765-8013",
"fax_number": "225-765-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8415 GOODWOOD BLVD STE 202",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708067851",
"telephone_number": "225-765-8013",
"fax_number": "225-765-2033"
}
],
"practiceLocations": [
{
"address_1": "8300 Constantin Blvd",
"address_purpose": "LOCATION",
"city": "Baton Rouge",
"state": "LA",
"postal_code": "708093489",
"country_code": "US",
"telephone_number": "225-374-4325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "KAITLIN",
"middle_name": "FAY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-05",
"last_updated": "2023-04-25",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "322814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.