Active NPI
Joseph Cedric Evans Jr., M.D.
- Surgery Physician
- Independence, MO
National Provider Identifier
1144206947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD32823
- Practice address
- 19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6904 - Phone
- (816) 254-9292
- Fax
- (816) 795-8996
- NPI assigned
- Dec 22, 2005
- Last updated
- May 2, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD32823 | MO | Primary |
Addresses
Primary practice location
19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6904
Mailing address
19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6904
Phone (816) 254-9292
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04537013 | Other | MO | BLUE CROSS-BLUE SHIELD |
| 200010403 | Medicaid | MO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD32823 | MO | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Care of Independence, Inc | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba United Surgical Associates of Kansas City
- Surgery Physician
- Independence, MO
- NPI 1568440493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1144206947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19101 E VALLEY VIEW PKWY",
"address_2": "SUITE B",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640556904",
"telephone_number": "816-254-9292",
"fax_number": "816-795-8996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19101 E VALLEY VIEW PKWY",
"address_2": "SUITE B",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640556904",
"telephone_number": "816-254-9292",
"fax_number": "816-795-8996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JOSEPH",
"middle_name": "CEDRIC",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "MD32823",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-BLUE SHIELD",
"identifier": "04537013",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200010403",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.