Individual provider Active NPI

Montesha Sherrelle Evans, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1336693159
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5008804 Issued in NC
Practice address
1337 E Garrison Blvd
Gastonia, NC 28054-5127
Phone
(704) 865-3848
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008804 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5008804 NC Primary
Nurse Practitioner 363L00000X 5008804 NC

Addresses

Primary practice location

1337 E Garrison Blvd
Gastonia, NC 28054-5127

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 671-5343

Other practice location 1

2550 Court Dr Ste 103
Gastonia, NC 28054-2152
Phone (704) 215-5822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20161115000950 NC Practitioner - Nurse Practitioner 8527347509 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5008804NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 19, 2024 Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 19, 2024 Accepting new patients
Support Incorporated Nurse Practitioner CurrentSince Jul 30, 2019 Accepting new patients
A Brighter Path LLC Current Accepting new patients
A Bridge to Healing, PLLC Psychiatric/Mental Health Past Accepting new patients

Locations

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

1337 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 671-5313

708 S Chestnut St
Gastonia, NC 28054
Phone (704) 854-4840

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1336693159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-671-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-865-3848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Court Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542152",
            "country_code": "US",
            "telephone_number": "704-215-5822",
            "fax_number": "704-215-5824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MONTESHA",
        "middle_name": "SHERRELLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008804",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5008804",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.