Individual provider Active NPI

Marsha Evans, ANP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1245208172
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP1619 Issued in AZ
Practice address
20040 N 19TH Ave
Suite a
Phoenix, AZ 85027-4255
Phone
(623) 869-5000
Fax
(623) 869-0927
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP1619 AZ Primary

Addresses

Primary practice location

20040 N 19TH Ave
Suite a
Phoenix, AZ 85027-4255

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 838-8265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040927000180 AZ Practitioner - Nurse Practitioner 3577532654 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP1619AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Apr 13, 2020 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Apr 13, 2020 Accepting new patients
Consultants in Internal Medicine, P.C. CurrentSince Jul 1, 2015 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

5651 W Talavi Blvd
Ste 170
Glendale, AZ 85306
Phone (602) 843-1313

5701 W Talavi Blvd
Ste 110
Glendale, AZ 85306
Phone (602) 843-1313

20040 N 19th Ave
Ste A
Phoenix, AZ 85027
Phone (623) 869-5000

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1245208172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-838-8265",
            "fax_number": "702-804-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20040 N 19TH AVE",
            "address_2": "SUITE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274255",
            "telephone_number": "623-869-5000",
            "fax_number": "623-869-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARSHA",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP1619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.