Individual provider Active NPI

John N Evans, DPM

  • Foot & Ankle Surgery Podiatrist
  • Allen Park, MI
National Provider Identifier
1174502942
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901001476 Issued in MI
Practice address
8025 Allen Rd
Allen Park, MI 48101-1705
Phone
(313) 386-0080
Fax
(313) 383-7120
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901001476 MI Primary

Addresses

Primary practice location

8025 Allen Rd
Allen Park, MI 48101-1705

Mailing address

8025 Allen Rd.
Allen Park, MI 48101
Phone (313) 386-0080

Other identifiers 1

IdentifierTypeStateIssuer
2704580MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040630000691 MI Practitioner - Podiatry 0143207985 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Jul 1, 2023 Accepting new patients
Jawad a Shah MD PC CurrentSince Feb 1, 2023 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Jul 1, 2023 Accepting new patients
Michigan Healthcare Professionals PC Current Accepting new patients
Jawad a Shah, MD PC CurrentSince Feb 1, 2023 Accepting new patients

Locations

8025 Allen Rd
#7091
Allen Park, MI 48101
Phone (313) 386-0080

8025 Allen Rd
Allen Park, MI 48101
Phone (313) 386-0080

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1174502942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 ALLEN RD.",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "48101",
            "telephone_number": "313-386-0080",
            "fax_number": "313-383-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011705",
            "telephone_number": "313-386-0080",
            "fax_number": "313-383-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "N",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2704580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

Verify at the official NPI Registry.