Mark A Evans, PA-C

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

OK802 Issued in OK

Practice address

417 N Main
Grainte, OK 73547

Phone

(580) 872-4362

Fax

(877) 785-6691

NPI assigned

Sep 29, 2006

Last updated

Aug 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kiowa County Hospital AuthorityGroup PAC ID 7416948500, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Triad Home Health LLC Home health agency, Mangum, OK, CCN 377747
• Elkview General Hospital Hospital, Hobart, OK, CCN 370783
• Jackson County Memorial Hospital Authority Hospital, Altus, OK, CCN 370022

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IAHCBD/Endpoint/IAHCBD

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.

• Kiowa County Hospital Authority

  dba Elkview General Hospital

  • Rural Acute Care Hospital
  • Hobart, OK
  • NPI 1699758086
  Medicare reassignment Care Compare group NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  Care Compare affiliation
• Kiowa County Hospital Authority

  dba Elkview General Hospital

  • Rural Acute Care Hospital
  • Hobart, OK
  • NPI 1699758086
  Care Compare affiliation
• Triad Home Health LLC

  • Home Health Agency
  • Mangum, OK
  • NPI 1083921795
  Care Compare affiliation

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1205928983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 476",
            "city": "GRANITE",
            "state": "OK",
            "postal_code": "73547",
            "telephone_number": "580-872-4362",
            "fax_number": "877-785-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N MAIN",
            "city": "GRAINTE",
            "state": "OK",
            "postal_code": "73547",
            "telephone_number": "580-872-4362",
            "fax_number": "877-785-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "802",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "OK802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699750C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100054690A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.