Individual provider Active NPI

Terri Jo Evans, FNP

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1215667175
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704207516 Issued in MI
Practice address
5623 Gull Rd Ste 500
Kalamazoo, MI 49048-1098
Phone
(269) 775-8031
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704207516 MI Primary

Addresses

Primary practice location

5623 Gull Rd Ste 500
Kalamazoo, MI 49048-1098

Mailing address

601 John Street
Box 42
Kalamazoo, MI 49007

Other practice location 1

1634 Gull Rd
Kalamazoo, MI 49048-1632
Phone (269) 903-2835

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220728002914 MI Practitioner - Nurse Practitioner 3173905775 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, shared by 3 NPIs, 721 clinicians

Practice addresses (Care Compare)

3300 W Centre Ave
Bronson OB GYN Associates
Portage, MI 49024-4666
Phone (269) 327-2211

5623 Gull Rd
Suite 500
Kalamazoo, MI 49048-1097
Phone (269) 775-8031

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704207516MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Mar 1, 2024 Accepting new patients
Bronson South Haven Hospital CurrentSince Mar 1, 2024 Accepting new patients
Bronson Battle Creek Hospital CurrentSince Mar 1, 2024 Accepting new patients
Bronson Battle Creek Hospital CurrentSince Mar 1, 2024 Accepting new patients
Bronson Lakeview Hospital CurrentSince Mar 1, 2024 Accepting new patients
Bronson South Haven Hospital CurrentSince Mar 1, 2024 Accepting new patients
Bronson Methodist Hospital Family CurrentSince Mar 1, 2024 Accepting new patients
Bronson Lakeview Hospital CurrentSince Mar 1, 2024 Accepting new patients

Locations

520 Railroad St
Bangor, MI 49013
Phone (269) 427-5811

2900 Watkins Rd
Battle Creek, MI 49015
Phone (269) 245-5430

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

1820 Shaffer St
Kalamazoo, MI 49048
Phone (269) 381-7136

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

5623 Gull Rd
Ste 500
Kalamazoo, MI 49048
Phone (269) 775-8031

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

212 Winston Dr
Marshall, MI 49068
Phone (269) 245-5460

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

3300 W Centre Ave
Portage, MI 49024
Phone (269) 324-8950

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

955 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-5271

930 Blue Star Hwy
South Haven, MI 49090
Phone (269) 637-1115

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1215667175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN STREET",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 GULL RD STE 500",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481098",
            "telephone_number": "269-775-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1634 Gull Rd",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481632",
            "country_code": "US",
            "telephone_number": "269-903-2835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "TERRI",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704207516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.