Teresa Claire Evan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53252 Issued in NM

Practice address

1515 W Fir St
Portales, NM 88130-5703

Phone

(575) 356-6695

Fax

(575) 356-5948

NPI assigned

Oct 14, 2014

Last updated

Nov 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reeves County Hospital District

  dba Reeves Regional Physician Clinic

  • Family Medicine Physician
  • Pecos, TX
  • NPI 1447417209
  Medicare reassignment NPD
• Reeves County Hospital District

  dba Reeves Regional Home Health & Hospice

  • Home Health Agency
  • Pecos, TX
  • NPI 1154869287
  NPD

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1124422597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W FIR ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881305703",
            "telephone_number": "575-359-3820",
            "fax_number": "575-346-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W FIR ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881305703",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Encino Pl NE Ste C14",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022643",
            "country_code": "US",
            "telephone_number": "505-272-1777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2323 Texas St",
            "address_purpose": "LOCATION",
            "city": "Pecos",
            "state": "TX",
            "postal_code": "797727338",
            "country_code": "US",
            "telephone_number": "432-447-3551",
            "fax_number": "432-447-5434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVAN",
        "first_name": "TERESA",
        "middle_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126422",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "53252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Portales, NM
• Providers in Portales, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.