Individual provider Active NPI

Jess G. Evans, PH.D

  • Clinical Laboratory Director (Non-physician)
  • Memphis, TN
National Provider Identifier
1336549971
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
ML0000023356 Issued in TN
Practice address
1701 Century Center CV
Memphis, TN 38134-8975
Phone
(901) 432-8605
Fax
(901) 844-8668
NPI assigned
Sep 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Laboratory Director (Non-physician) 247ZC0005X ML0000023356 TN Primary

Addresses

Primary practice location

1701 Century Center CV
Memphis, TN 38134-8975

Mailing address

1701 Century Center CV
Memphis, TN 38134-8975
Phone (901) 432-8605

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ML0000023356TNMDClinical Laboratory Director (Non-physician)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1336549971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 CENTURY CENTER CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381348975",
            "telephone_number": "901-432-8605",
            "fax_number": "901-844-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 CENTURY CENTER CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381348975",
            "telephone_number": "901-432-8605",
            "fax_number": "901-844-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JESS",
        "middle_name": "G.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "TN",
            "license": "ML0000023356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.