NPIMap

Individual provider Active NPI

Evan B Hurst, MD

  • Internal Medicine Physician
  • Jasper, IN
National Provider Identifier
1265460935
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10142311 Issued in IN
Practice address
800 W 9TH St
Jasper, IN 47546-2514
Phone
(812) 630-8660
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10142311 IN Primary

Addresses

Primary practice location

800 W 9TH St
Jasper, IN 47546-2514

Mailing address

PO Box 786
Jasper, IN 47547-0786
Phone (812) 630-8660

Other identifiers 2

IdentifierTypeStateIssuer
110147911OtherINRAILROAD MEDICARE
200048850AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100825000296 IN Practitioner - Internal Medicine 4688696370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 W 13TH St
Jasper, IN 47546-1882

800 W 9TH St
Jasper, IN 47546-2514

800 W 9TH St
Memorial Hospital and Health Care Center
Jasper, IN 47546-2516
Phone (812) 996-2345

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10142311INMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evan B Hurst, MD, Internal Medicine, PC CurrentSince Aug 15, 2013 Accepting new patients
Deaconess Memorial Medical Center Inc Internal Medicine CurrentSince Feb 1, 1999 Accepting new patients
Deaconess Memorial Medical Center Inc Current Accepting new patients
Deaconess Memorial Medical Center Inc CurrentSince Feb 1, 1999 Accepting new patients

Locations

600 W 13th St
Ste 100
Jasper, IN 47546
Phone (812) 996-2345

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

Interoperability endpoints

  • Direct secure messaging: ehurst21688@direct.mhhcc.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brookside Village, IncJasper, IN, CCN 155703 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 21, 2019
Jan 21, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 9

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1265460935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 786",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475470786",
            "telephone_number": "812-630-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462514",
            "telephone_number": "812-630-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "EVAN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "10142311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110147911",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200048850A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

Verify at the official NPI Registry.