Individual provider Active NPI

Donna Jean Evans, O.T.

  • Occupational Therapist
  • Beckley, WV
National Provider Identifier
1194887018
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1241 Issued in WV
Practice address
21 Osprey Rd
Beckley, WV 25801-1605
Phone
(304) 222-2329
Fax
(304) 253-8316
NPI assigned
Dec 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1241 WV Primary

Addresses

Primary practice location

21 Osprey Rd
Beckley, WV 25801-1605

Mailing address

21 Osprey Rd
Beckley, WV 25801-1605
Phone (304) 222-2329

Other identifiers 1

IdentifierTypeStateIssuer
7501013000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240112000556 WV Practitioner - Occupational Therapist in Private Practice 5597116798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1241WVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Outpatient Clinic LLC CurrentSince Jan 1, 2024 Accepting new patients
Sunshine Therapy Services Occupational Therapist Past Accepting new patients

Locations

1769 Robert C Byrd Dr
Beckley, WV 25801
Phone (304) 222-2329

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194887018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 OSPREY RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258011605",
            "telephone_number": "304-222-2329",
            "fax_number": "304-253-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 OSPREY RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258011605",
            "telephone_number": "304-222-2329",
            "fax_number": "304-253-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DONNA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7501013000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.