Active NPI
Evan Tank, DO
- Epilepsy Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Epilepsy Physician
- License
- 5101019162
- Practice address
- 275 Michigan St NE
Grand Rapids, MI 49503-2531 - Phone
- (616) 267-7900
- Fax
- (616) 267-7901
- NPI assigned
- Jul 12, 2011
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OP70051303 | WA | |
| Neurology Physician | 2084N0400X | 6514 | TN | |
| Neurology Physician | 2084N0400X | 0102207882 | VA | |
| Neurology Physician | 2084N0400X | 5101019162 | MI | |
| Epilepsy Physician | 2084E0001X | 5101019162 | MI | Primary |
| Neurology Physician | 2084N0400X | 02007671A | IN |
Addresses
Primary practice location
275 Michigan St NE
Grand Rapids, MI 49503-2531
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other practice location 1
1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-1103
Other practice location 2
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
Other practice location 3
1519 Main St
Sneedville, TN 37869-3657
Phone (423) 733-5070
Other practice location 4
851 Locust St
Rogersville, TN 37857-2407
Phone (423) 921-7000
Other practice location 5
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000
Other practice location 6
1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (276) 523-3111
Other practice location 7
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121
Other practice location 8
58 Carroll St
Lebanon, VA 24266-4510
Phone (276) 883-8000
Other practice location 9
601 John St Ste M-124
Kalamazoo, MI 49007-5377
Phone (269) 341-7500
Other practice location 10
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000
Other practice location 11
100 15th St NW
Norton, VA 24273-1616
Phone (276) 439-1000
Other practice location 12
127 Health Care Dr
Pennington Gap, VA 24277-2853
Phone (276) 546-5212
Other practice location 13
245 Medical Park Dr
Marion, VA 24354-1100
Phone (276) 378-1000
Other practice location 14
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000
Other practice location 15
2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000
Other practice location 16
1250 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-9350
Other practice location 17
1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-6239
Other practice location 18
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200
Other practice location 19
1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300
Other practice location 20
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000
Other practice location 21
312 Hospital Dr
Clintwood, VA 24228-6786
Phone (276) 926-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, VA, IN, NM, WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 6
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Michigan State University College of Osteopathic Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
1009 W Green St
Corewell Health Medical Group West
Hastings, MI 49058-1710
Phone (269) 945-1212
1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-6510
1200 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-9000
1250 E Marshall St
Richmond, VA 23298-5051
1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000
25 Michigan St NE
6100 Corewell Health Medical Group West
Grand Rapids, MI 49503-2561
Phone (616) 267-7900
275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 267-8700
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2042
300 N Ave
Battle Creek, MI 49017-3307
Phone (888) 258-0875
401 N 11TH St
Richmond, VA 23219-1914
Phone (804) 828-8737
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
605 Oak St
Big Rapids, MI 49307-2048
Phone (231) 592-4270
8333 Felch St
Zeeland, MI 49464-2608
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02007671A | IN | MD | Neurology Physician |
| 5101019162 | MI | MD | Neurology Physician |
| 6514 | TN | MD | Neurology Physician |
| 0102207882 | VA | MD | Neurology Physician |
| OP70051303 | WA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Medical Practices | Current | Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current | Accepting new patients | |
| Munson Medical Center | Neurology | Current | Accepting new patients |
| Franciscan Physician Network | Current | Accepting new patients | |
| Pathology Assoc of Southwestern Michigan, PC | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Munson Medical Center | Current | Accepting new patients | |
| Bronson Battle Creek Hospital | Current | Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current | Accepting new patients | |
| MCV Associated Physicians | Neurology | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Lakeland Medical Practices | Current | Accepting new patients | |
| Union Hospital, Inc. | Current | Accepting new patients | |
| Franciscan Physician Network | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Cibola General Hospital Corporation | Current | Accepting new patients | |
| Bronson Methodist Hospital | Neurology | Current | Accepting new patients |
| Bronson Battle Creek Hospital | Neurology | Current | Accepting new patients |
| Lakeland Hospitals at Niles and St Joseph, Inc | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Munson Medical Center | Current | Accepting new patients | |
| Lakeland Hospitals at Niles and St Joseph, Inc | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Metropolitan Hospital | Psychiatry | Current | Accepting new patients |
| Union Hospital, Inc. | Current | Accepting new patients | |
| Metropolitan Hospital | Past | Accepting new patients | |
| Metropolitan Hospital | Past | Accepting new patients | |
| Union Hospital Inc | Past | Accepting new patients | |
| Spectrum Health Hospitals | Past | Accepting new patients |
Locations (25 of 26)
2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031
1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120
1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400
150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211
1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523
300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862
300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000
2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015
275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900
25 Michigan St NE
Ste 6100
Grand Rapids, MI 49503
Phone (616) 267-7900
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111
5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243
1423 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-6500
1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409
1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990
Interoperability endpoints
- etank5332441@direct.casso.us.com
- etank1309570@ahs.direct-ci.com
- etank121948@epic00.corewelldirect.org
- https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Organizations & group practices 33
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endocrinology, Diabetes & Metabolism Physician
- Traverse City, MI
- NPI 1083761860
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Rural Health Clinic/Center
- Hartford, MI
- NPI 1023114741
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
-
- Internal Medicine Physician
- Saint Joseph, MI
- NPI 1538397120
-
- Critical Access Hospital
- Grants, NM
- NPI 1780677039
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- General Acute Care Hospital
- Owensboro, KY
- NPI 1285613612
-
- General Acute Care Hospital
- Richmond, VA
- NPI 1013091727
-
- General Acute Care Hospital
- Richmond, VA
- NPI 1437175734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778198400000",
"number": "1124316054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032531",
"telephone_number": "616-267-7900",
"fax_number": "616-267-7901"
}
],
"practiceLocations": [
{
"address_1": "1901 S Shady St",
"address_purpose": "LOCATION",
"city": "Mountain City",
"state": "TN",
"postal_code": "376832021",
"country_code": "US",
"telephone_number": "423-727-1103",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 N State of Franklin Rd",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046035",
"country_code": "US",
"telephone_number": "423-431-6111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1519 Main St",
"address_purpose": "LOCATION",
"city": "Sneedville",
"state": "TN",
"postal_code": "378693657",
"country_code": "US",
"telephone_number": "423-733-5070",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "851 Locust St",
"address_purpose": "LOCATION",
"city": "Rogersville",
"state": "TN",
"postal_code": "378572407",
"country_code": "US",
"telephone_number": "423-921-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Med Tech Pkwy",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376042277",
"country_code": "US",
"telephone_number": "423-302-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1990 Holton Ave E",
"address_purpose": "LOCATION",
"city": "Big Stone Gap",
"state": "VA",
"postal_code": "242193350",
"country_code": "US",
"telephone_number": "276-523-3111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Park Blvd",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207430",
"country_code": "US",
"telephone_number": "423-844-1121",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "58 Carroll St",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "VA",
"postal_code": "242664510",
"country_code": "US",
"telephone_number": "276-883-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "601 John St Ste M-124",
"address_purpose": "LOCATION",
"city": "Kalamazoo",
"state": "MI",
"postal_code": "490075377",
"country_code": "US",
"telephone_number": "269-341-7500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "130 W Ravine Rd",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376603837",
"country_code": "US",
"telephone_number": "423-224-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 15th St NW",
"address_purpose": "LOCATION",
"city": "Norton",
"state": "VA",
"postal_code": "242731616",
"country_code": "US",
"telephone_number": "276-439-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "127 Health Care Dr",
"address_purpose": "LOCATION",
"city": "Pennington Gap",
"state": "VA",
"postal_code": "242772853",
"country_code": "US",
"telephone_number": "276-546-5212",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "245 Medical Park Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "VA",
"postal_code": "243541100",
"country_code": "US",
"telephone_number": "276-378-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16000 Johnston Memorial Dr",
"address_purpose": "LOCATION",
"city": "Abingdon",
"state": "VA",
"postal_code": "242117664",
"country_code": "US",
"telephone_number": "276-258-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2000 Brookside Dr",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376604627",
"country_code": "US",
"telephone_number": "423-857-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1250 E Marshall St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985023",
"country_code": "US",
"telephone_number": "804-828-9350",
"fax_number": "804-807-7949",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1105 Sixth St",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496842345",
"country_code": "US",
"telephone_number": "231-935-6239",
"fax_number": "231-935-7251",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2801 N Gantenbein Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271623",
"country_code": "US",
"telephone_number": "503-413-2200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1501 W Elk Ave",
"address_purpose": "LOCATION",
"city": "Elizabethton",
"state": "TN",
"postal_code": "376432874",
"country_code": "US",
"telephone_number": "423-542-1300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1420 Tusculum Blvd",
"address_purpose": "LOCATION",
"city": "Greeneville",
"state": "TN",
"postal_code": "377454279",
"country_code": "US",
"telephone_number": "423-787-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "312 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Clintwood",
"state": "VA",
"postal_code": "242286786",
"country_code": "US",
"telephone_number": "276-926-0300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANK",
"first_name": "EVAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-12",
"last_updated": "2026-05-08",
"certification_date": "2026-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "OP70051303",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "6514",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "VA",
"license": "0102207882",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "5101019162",
"primary": false
},
{
"code": "2084E0001X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Epilepsy",
"state": "MI",
"license": "5101019162",
"primary": true
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IN",
"license": "02007671A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.