Jaime Lynn Evanshine, CNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

COA.15262-NP Issued in OH

Practice address

630 W Main St
Suite 307
Wilmington, OH 45177-2170

Phone

(937) 383-1588

Fax

(937) 383-4525

NPI assigned

Oct 22, 2013

Last updated

Oct 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

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.

• South Central Ohio Obstetrics and Gynecology, Inc

  • Obstetrics & Gynecology Physician
  • Wilmington, OH
  • NPI 1629038203
  Medicare reassignment

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1346678760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 ROMANS RD",
            "city": "NEW VIENNA",
            "state": "OH",
            "postal_code": "451599239",
            "telephone_number": "937-725-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAIN ST",
            "address_2": "SUITE 307",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772170",
            "telephone_number": "937-383-1588",
            "fax_number": "937-383-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANSHINE",
        "first_name": "JAIME",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "COA.15262-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094249",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy A Erbaugh, RN
• Eric Mersch D.C., LLC
• Kassidy Lynne Esser, ATC
• Kaitlin Eileen Evans
• Michelle Lynn Evans
• Extended Family Home Health Services LLC
• Eye Services LLC
• Eye Specialist Inc
• Carrie B Fairchild, PA
• Fairway Behavioral Health, LLC

• Women's Health Nurse Practitioner in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Women's Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.