Individual provider Active NPI

John Denoon Evans, M.D.

  • Ophthalmology Physician
  • Portsmouth, OH
National Provider Identifier
1386646644
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35078998E Issued in OH
Practice address
1534 11TH St
Portsmouth, OH 45662-4524
Phone
(740) 355-1161
Fax
(740) 355-1191
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35078998E OH Primary

Addresses

Primary practice location

1534 11TH St
Portsmouth, OH 45662-4524

Mailing address

1534 11TH St
Portsmouth, OH 45662-4524
Phone (740) 355-1161

Other identifiers 1

IdentifierTypeStateIssuer
2270331MedicaidOH

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000214 OH Practitioner - Ophthalmology 3678522414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1534 11TH St
Portsmouth, OH 45662-4524
Phone (740) 355-1161

Hospital & facility affiliations

  • Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35078998EOHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Evans MD Ophthalmology Inc Ophthalmology CurrentSince Mar 28, 2008 Accepting new patients
Richard a Eiferman, PSC Ophthalmology Past Accepting new patients
Southern Ohio Eye Surgical Associates LLC Ophthalmology PastSince Jan 1, 2020 Accepting new patients
Southern Ohio Ophthalmic Anesthesia, LLC Past Accepting new patients
Robert J. Knox MD, Inc Past Accepting new patients

Locations

1534 11th St
Portsmouth, OH 45662
Phone (740) 355-1161

Interoperability endpoints

  • Direct secure messaging: jr.1@somc.medicity.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1386646644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 11TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624524",
            "telephone_number": "740-355-1161",
            "fax_number": "740-355-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 11TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624524",
            "telephone_number": "740-355-1161",
            "fax_number": "740-355-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "DENOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35078998E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2270331",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.