NPIMap

Individual provider Active NPI

Joshua Mark Evans, D.O.

  • Internal Medicine Physician
  • Bowie, TX
National Provider Identifier
1376830539
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q0042 Issued in TX
Practice address
1010 N Mill St
Bowie, TX 76230-3120
Phone
(940) 872-1121
NPI assigned
Jul 7, 2011
Last updated
Feb 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q0042 TX Primary

Addresses

Primary practice location

1010 N Mill St
Bowie, TX 76230-3120

Mailing address

1010 N Mill St
Bowie, TX 76230-3120
Phone (940) 872-1121

Other identifiers 1

IdentifierTypeStateIssuer
338413301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140903001894 TX Practitioner - Internal Medicine 4688803109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jack County Hospital DistrictGroup PAC ID 5890768675, 20 clinicians

Practice addresses (Care Compare)

215 Chisholm TRL
Jacksboro, TX 76458-1403
Phone (940) 567-6633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Jack County Hospital District CurrentSince Sep 20, 2017 Accepting new patients
Jack County Hospital District CurrentSince Sep 20, 2017 Accepting new patients
Nocona Hospital District Past Accepting new patients
Jack County Hospital District Past Accepting new patients

Locations

1010 N Mill St
Bowie, TX 76230
Phone (817) 872-1121

215 Chisholm Trl
Jacksboro, TX 76458
Phone (940) 567-5528

Interoperability endpoints

  • Direct secure messaging: joshua.evans.1@11284.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1376830539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N MILL ST",
            "city": "BOWIE",
            "state": "TX",
            "postal_code": "762303120",
            "telephone_number": "940-872-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N MILL ST",
            "city": "BOWIE",
            "state": "TX",
            "postal_code": "762303120",
            "telephone_number": "940-872-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOSHUA",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q0042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338413301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, TX

Sources for this page

Verify at the official NPI Registry.