Individual provider Active NPI

Bridgette Elaine Evans, LCSW

  • Clinical Social Worker
  • Wasilla, AK
National Provider Identifier
1306490651
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
195464 Issued in AK
Practice address
1075 S Check St Ste 110
Wasilla, AK 99654-8067
Phone
(912) 318-2329
NPI assigned
Jul 25, 2019
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 195464 AK Primary

Addresses

Primary practice location

1075 S Check St Ste 110
Wasilla, AK 99654-8067

Mailing address

401 N Main St 870630
Wasilla, AK 99687

Other practice location 1

591 S Knik Goose Bay Rd
Wasilla, AK 99654-8062
Phone (907) 313-1333

Other identifiers 1

IdentifierTypeStateIssuer
1735622MedicaidAK

Other names 1

  • Bridgette Adkins Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251231002704 AK Practitioner - Clinical Social Worker 4183110927 Practice locations: Wasilla, AK

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1075 S Check St
Suite 110
Wasilla, AK 99654-8067
Phone (907) 376-3539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
195464AKMDClinical Social Worker

Organizations & group practices 1

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1306490651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST 870630",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 S CHECK ST STE 110",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548067",
            "telephone_number": "912-318-2329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "591 S Knik Goose Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996548062",
            "country_code": "US",
            "telephone_number": "907-313-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BRIDGETTE",
        "middle_name": "ELAINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "195464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1735622",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETTE",
            "last_name": "ADKINS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.