Individual provider Active NPI

Stephen Ray Evans, LCSW

  • Clinical Social Worker
  • Paragould, AR
National Provider Identifier
1356696694
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
28 Southpointe Dr
Paragould, AR 72450-6238
Phone
(870) 239-2244
NPI assigned
Jul 23, 2012
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10195-M AR
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

28 Southpointe Dr
Paragould, AR 72450-6238

Mailing address

28 Southpointe Dr
Paragould, AR 72450-6238
Phone (870) 239-2244

Other names 1

  • Stephen Ray Evans Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829003766 AR Practitioner - Clinical Social Worker 7618330267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arisa Health IncGroup PAC ID 2264853829, 65 clinicians

Practice addresses (Care Compare)

28 Southpointe Dr
Paragould, AR 72450-6238
Phone (870) 239-2244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10195-MARMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arisa Health, Inc. CurrentSince Jul 17, 2023 Accepting new patients
Arisa Health, Inc. Social Worker CurrentSince Jul 17, 2023 Accepting new patients

Locations

2707 Browns Ln
Jonesboro, AR 72401
Phone (870) 972-4000

28 Southpointe Dr
Paragould, AR 72450
Phone (870) 239-2244

2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1356696694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 SOUTHPOINTE DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724506238",
            "telephone_number": "870-239-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 SOUTHPOINTE DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724506238",
            "telephone_number": "870-239-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "STEPHEN",
        "middle_name": "RAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "10195-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHEN",
            "last_name": "EVANS",
            "middle_name": "RAY",
            "credential": "MHW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.