Active NPI
Thomas Michael Evans II
- Clinical Psychologist
- North Ridgeville, OH
National Provider Identifier
1346574142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5051
- Practice address
- 35590 Center Ridge Rd
102
North Ridgeville, OH 44039-6000 - Phone
- (440) 327-2388
- NPI assigned
- Sep 25, 2009
- 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 |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 5051 | OH | |
| Clinical Psychologist | 103TC0700X | 5051 | OH | Primary |
Addresses
Primary practice location
35590 Center Ridge Rd
102
North Ridgeville, OH 44039-6000
Mailing address
35590 Center Ridge Rd
102
North Ridgeville, OH 44039-6000
Phone (440) 327-2388
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5051 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253836800000",
"number": "1346574142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35590 CENTER RIDGE RD",
"address_2": "102",
"city": "NORTH RIDGEVILLE",
"state": "OH",
"postal_code": "440396000",
"telephone_number": "440-327-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35590 CENTER RIDGE RD",
"address_2": "102",
"city": "NORTH RIDGEVILLE",
"state": "OH",
"postal_code": "440396000",
"telephone_number": "440-327-2388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-25",
"last_updated": "2009-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "OH",
"license": "5051",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Ridgeville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.