Individual provider Active NPI

Judith Florence Evans

  • Counselor
  • Fairbanks, AK
National Provider Identifier
1114530003
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3100 S Cushman St
Fairbanks, AK 99701-7516
Phone
(907) 452-6251
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X AK Primary

Addresses

Primary practice location

3100 S Cushman St
Fairbanks, AK 99701-7516

Mailing address

2440 Caddis CT Apt 3
North Pole, AK 99705-8410
Phone (907) 978-2010

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

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1114530003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 CADDIS CT APT 3",
            "city": "NORTH POLE",
            "state": "AK",
            "postal_code": "997058410",
            "telephone_number": "907-978-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017516",
            "telephone_number": "907-452-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JUDITH",
        "middle_name": "FLORENCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.