Individual provider Active NPI

Catherine A Evans, PH D

  • Psychologist
  • West Des Moines, IA
National Provider Identifier
1124005129
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00258 Issued in IA
Practice address
1001 Office Park Rd
Suite 301
West Des Moines, IA 50265-2587
Phone
(515) 985-8209
Fax
(515) 608-4405
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00258 IA Primary
Clinical Neuropsychologist 103G00000X 00666 IA

Addresses

Primary practice location

1001 Office Park Rd
Suite 301
West Des Moines, IA 50265-2587

Mailing address

1001 Office Park Rd
Suite 301
West Des Moines, IA 50265-2587
Phone (515) 985-8209

Other identifiers 2

IdentifierTypeStateIssuer
1124005129MedicaidIA
620003472OtherIARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100215000093 IA Practitioner - Clinical Psychologist 6002950003

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

403 W Cool Dr
Suite 107
Tucson, AZ 85704-6551

4861 N Calle Bujia
Tucson, AZ 85718-6168

525 W Brown Rd
Mesa, AZ 85201-3202

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00258IAMDPsychologist
00666IAMDPodiatrist

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1124005129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 OFFICE PARK RD",
            "address_2": "SUITE 301",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652587",
            "telephone_number": "515-985-8209",
            "fax_number": "515-608-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 OFFICE PARK RD",
            "address_2": "SUITE 301",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652587",
            "telephone_number": "515-985-8209",
            "fax_number": "515-608-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "CATHERINE",
        "middle_name": "A",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00258",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IA",
            "license": "00666",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124005129",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "620003472",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.