Evan James Gorgas

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

5333 McAuley Dr RM 2115
Ypsilanti, MI 48197-1097

Phone

(734) 712-3971

NPI assigned

Apr 19, 2021

Last updated

Apr 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1174104483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SPRUCE HILL LN",
            "city": "ORTONVILLE",
            "state": "MI",
            "postal_code": "484628538",
            "telephone_number": "248-568-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 2115",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971097",
            "telephone_number": "734-712-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORGAS",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Gopi Nagaruri
• Tauqir Goraya, MD
• Dennis Gordon, RD
• Katharine Lyn Gordon, LMSW
• Breanna N Gore
• Dakota J Goris
• Quinn James Gormley-Veasley
• Jennifer Ann Gossett, CTRS
• Sunaina Gowda Ramesh Babu, MD
• Markeeta Lorraine Graban, L.M.S.W.

• Student in an Organized Health Care Education/Training Program in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.