Individual provider Active NPI

Evelyn C Brister, MD

  • Obstetrics & Gynecology Physician
  • Canton, OH
National Provider Identifier
1316956006
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35069369B Issued in OH
Practice address
4151 Holiday St NW
Canton, OH 44718-2531
Phone
(330) 492-8001
Fax
(330) 492-2080
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35069369B OH Primary

Addresses

Primary practice location

4151 Holiday St NW
Canton, OH 44718-2531

Mailing address

4151 Holiday St NW
Canton, OH 44718-2531
Phone (330) 492-8001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100325001051 OH Practitioner - Obstetrics/Gynecology 1557395126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northeastern Ohio University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium OB/GYN., Inc.Group PAC ID 2163473091, 8 clinicians

Practice addresses (Care Compare)

4151 Holiday St NW
Canton, OH 44718-2531
Phone (330) 649-4218

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069369BOHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stark County Women's Clinic Inc Obstetrics & Gynecology Current Accepting new patients
Atrium OB/GYN., Inc. CurrentSince Aug 2, 2024 Accepting new patients

Locations

5000 Higbee Ave NW
Canton, OH 44718
Phone (330) 493-0313

4151 Holiday St NW
Canton, OH 44718
Phone (330) 492-8001

4347 Portage St NW
Ste 102
North Canton, OH 44720

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 4

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1316956006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182531",
            "telephone_number": "330-492-8001",
            "fax_number": "330-492-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182531",
            "telephone_number": "330-492-8001",
            "fax_number": "330-492-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTER",
        "first_name": "EVELYN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35069369B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.