NPIMap

Individual provider Active NPI

Thomas Edwin Evans, M. D.

  • Family Medicine Physician
  • Seneca, SC
National Provider Identifier
1255339131
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20498 Issued in SC
Practice address
11082 N Radio Station Rd
Seneca, SC 29678-1142
Phone
(864) 882-2314
Fax
(864) 882-3677
NPI assigned
Jul 13, 2005
Last updated
Sep 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20498 SC Primary

Addresses

Primary practice location

11082 N Radio Station Rd
Seneca, SC 29678-1142

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044

Other identifiers 4

IdentifierTypeStateIssuer
GP4697MedicaidSC
080165039OtherSCRAILROAD MEDICARE
20-8715655OtherSCFACILITY TAX ID
Q33321MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090919000000 SC Practitioner - Family Practice 6305992173 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Emory University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians

Practice addresses (Care Compare)

11082 N Radio Station Rd
Seneca, SC 29678-1142
Phone (864) 882-2314

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20498SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Oct 1, 2014 Accepting new patients
Greenville Health System CurrentSince Mar 22, 2015 Accepting new patients
Prisma Health University Medical Group Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Greenville Health System CurrentSince Mar 22, 2015 Accepting new patients
GHS Partners in Health, Inc. Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Prisma Health-Upstate Past Accepting new patients
Ball Ground Family Practice,P.C. Family Medicine Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

100 Omni Dr
#A
Seneca, SC 29672
Phone (864) 885-7520

10110 Clemson Blvd
Seneca, SC 29678
Phone (864) 482-0500

11082 N Radio Station Rd
Seneca, SC 29678
Phone (864) 882-2314

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

772 N Townville St
Seneca, SC 29678
Phone (864) 886-9300

Interoperability endpoints

  • Direct secure messaging: tevans53587@direct.ghs.myhfn.org

Organizations & group practices 9

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.

Hospital & facility affiliations 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1255339131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11082 N RADIO STATION RD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296781142",
            "telephone_number": "864-882-2314",
            "fax_number": "864-882-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "THOMAS",
        "middle_name": "EDWIN",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "20498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4697",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080165039",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY TAX ID",
            "identifier": "20-8715655",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q33321",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.