Active NPI
William S Evans, MD
- Vascular Surgery Physician
- Cody, WY
National Provider Identifier
1306819974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- TL#1137
- Practice address
- 424 Yellowstone Ave
Ste 2D
Cody, WY 82414 - Phone
- (307) 578-2947
- Fax
- (307) 578-2492
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 27613020 | WI | |
| Vascular Surgery Physician | 2086S0129X | TL#1137 | WY | Primary |
Addresses
Primary practice location
424 Yellowstone Ave
Ste 2D
Cody, WY 82414
Mailing address
707 Sheridan Ave
Cody, WY 82414
Phone (307) 578-2480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31513900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27613020 | WI | MD | Vascular Surgery Physician |
| TL#1137 | WY | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wisconsin Heart, S.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Madison, WI
- NPI 1720051857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245110400000",
"number": "1306819974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SHERIDAN AVE",
"city": "CODY",
"state": "WY",
"postal_code": "82414",
"telephone_number": "307-578-2480",
"fax_number": "307-578-2492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 YELLOWSTONE AVE",
"address_2": "STE 2D",
"city": "CODY",
"state": "WY",
"postal_code": "82414",
"telephone_number": "307-578-2947",
"fax_number": "307-578-2492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "WILLIAM",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2009-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WI",
"license": "27613020",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WY",
"license": "TL#1137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31513900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cody, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.