Individual provider Active NPI

Sean Spencer Evans, MD

  • Pediatric Otolaryngology Physician
  • Atlanta, GA
National Provider Identifier
1255759494
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
85897 Issued in GA
Practice address
1400 Tullie Rd NE FL 1
Atlanta, GA 30329-2309
Phone
(404) 785-5437
Fax
(404) 785-9111
NPI assigned
Apr 4, 2014
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 85897 GA Primary

Addresses

Primary practice location

1400 Tullie Rd NE FL 1
Atlanta, GA 30329-2309

Mailing address

1400 Tullie Rd NE FL 1
Atlanta, GA 30329-2309
Phone (404) 785-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908000387 GA Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 7315170750 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Sep 14, 2020 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 14, 2020 Accepting new patients
The Emory Clinic Inc CurrentSince Sep 14, 2020 Accepting new patients
Scottish Rite Children's Medical Center PastSince Jun 27, 2021 Accepting new patients
Emory Health Care Past Accepting new patients
Choa Multispecialty, LLC Pediatric Otolaryngology Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Organizations & group practices 7

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1255759494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SEAN",
        "middle_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2022-06-06",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "GA",
            "license": "85897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1400 Tullie Rd NE Fl 1",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303292309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.