Active NPI
James L Evers, PT
- Physical Therapist
- Sturgeon Bay, WI
National Provider Identifier
1164549820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10964-24
- Practice address
- 1300 Egg Harbor Rd Ste 152
Sturgeon Bay, WI 54235-1248 - Phone
- (920) 746-0410
- Fax
- (920) 746-0244
- NPI assigned
- Mar 26, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10964-24 | WI | Primary |
Addresses
Primary practice location
1300 Egg Harbor Rd Ste 152
Sturgeon Bay, WI 54235-1248
Mailing address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36159900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190719000193 | WI | Practitioner - Physical Therapist in Private Practice | 8224364823 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10964-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1164549820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 S 18TH AVE",
"city": "STURGEON BAY",
"state": "WI",
"postal_code": "542351401",
"telephone_number": "920-743-5566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 EGG HARBOR RD STE 152",
"city": "STURGEON BAY",
"state": "WI",
"postal_code": "542351248",
"telephone_number": "920-746-0410",
"fax_number": "920-746-0244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERS",
"first_name": "JAMES",
"middle_name": "L",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10964-24",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36159900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sturgeon Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.