Individual provider Active NPI

Kenneth Marcus Evans, PA

  • Physician Assistant
  • Champaign, IL
National Provider Identifier
1326720202
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010015 Issued in IL
Practice address
3101 Fields South Dr
Champaign, IL 61822-3743
Phone
(217) 366-6162
NPI assigned
Aug 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085010015 IL Primary

Addresses

Primary practice location

3101 Fields South Dr
Champaign, IL 61822-3743

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-6162

Other practice location 1

1000 Central St.
Suite 717
Evanstion, IL 60201-1779
Phone (847) 657-1900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kevansmd401469@CarleHieDirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131003368 IL Practitioner - Physician Assistant 1850744327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1200

109 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-5180

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085010015ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Feb 1, 2026 Accepting new patients
Christie Clinic, PLLC CurrentSince Jan 8, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 1, 2026 Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

3101 Fields South Dr
Champaign, IL 61822
Phone (217) 366-1237

1000 Central St
Ste 717
Evanston, IL 60201
Phone (847) 328-5180

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

Interoperability endpoints

  • Direct secure messaging: kevansmd401469@carlehiedirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1326720202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223743",
            "telephone_number": "217-366-6162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Central St.",
            "address_2": "Suite 717",
            "address_purpose": "LOCATION",
            "city": "Evanstion",
            "state": "IL",
            "postal_code": "602011779",
            "country_code": "US",
            "telephone_number": "847-657-1900",
            "fax_number": "847-733-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KENNETH",
        "middle_name": "MARCUS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-01",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevansmd401469@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3101 Fields South Dr",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618223743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.