Active NPI
R. Blair Evans, M.D.
- Ophthalmology Physician
- Seattle, WA
National Provider Identifier
1114905635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD00018428
- Practice address
- 1101 Madison St
Suite 600
Seattle, WA 98104-1306 - Phone
- (206) 215-2020
- Fax
- (206) 215-2022
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD00018428 | WA | Primary |
Addresses
Primary practice location
1101 Madison St
Suite 600
Seattle, WA 98104-1306
Mailing address
1101 Madison St
Suite 600
Seattle, WA 98104-1306
Phone (206) 215-2004
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8163107 | Medicaid | WA | |
| 180016726 | Other | RAILROAD MEDICARE | |
| E781 | Other | REGENCE HEALTHCARE | |
| 0036110 | Other | WA | LABOR & INDUSTRIES |
Other names 1
- Robert Blair Evans
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114905635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 MADISON ST",
"address_2": "SUITE 600",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041306",
"telephone_number": "206-215-2004",
"fax_number": "206-215-2055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 MADISON ST",
"address_2": "SUITE 600",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041306",
"telephone_number": "206-215-2020",
"fax_number": "206-215-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "R.",
"middle_name": "BLAIR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WA",
"license": "MD00018428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8163107",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180016726",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE HEALTHCARE",
"identifier": "E781",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0036110",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ROBERT",
"last_name": "EVANS",
"middle_name": "BLAIR",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.