Active NPI
Richard A. Evans, M.D.
- Surgery Physician
- Dover Foxcroft, ME
National Provider Identifier
1114060423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 013561
- Practice address
- 14 Winter St
Dover Foxcroft, ME 04426-1023 - Phone
- (207) 564-0715
- Fax
- (207) 564-0717
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 013561 | ME | Primary |
Addresses
Primary practice location
14 Winter St
Dover Foxcroft, ME 04426-1023
Mailing address
14 Winter St
Dover Foxcroft, ME 04426-1023
Phone (207) 564-0715
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3128758 | Other | ME | AETNA - HMO |
| 180290000 | Medicaid | ME | |
| 5504468 | Other | ME | AETNA - NON-HMO |
| 57-1152681 | Other | ME | CIGNA AND OTHERS |
| P00018335 | Other | ME | RAILROAD MEDICARE |
| 060452 | Other | ME | ANTHEM |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013561 | ME | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1114060423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WINTER ST",
"city": "DOVER FOXCROFT",
"state": "ME",
"postal_code": "044261023",
"telephone_number": "207-564-0715",
"fax_number": "207-564-0717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 WINTER ST",
"city": "DOVER FOXCROFT",
"state": "ME",
"postal_code": "044261023",
"telephone_number": "207-564-0715",
"fax_number": "207-564-0717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "RICHARD",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ME",
"license": "013561",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA - HMO",
"identifier": "3128758",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180290000",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA - NON-HMO",
"identifier": "5504468",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA AND OTHERS",
"identifier": "57-1152681",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00018335",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "060452",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover Foxcroft, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.