Samuel Charles Evans, M.D.
Individual provider Active NPI Adult Medicine Physician · West Plains, MO
NPI 1407197684 · NPPES record last updated Sep 30, 2020
Key facts
- NPI
- 1407197684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- License
- 2020012799 (MO)
- Practice address
- 181 N Kentucky Ave Ste 100
West Plains, MO 65775-2092 - Phone
- (417) 257-5911
- Fax
- (417) 257-5913
- NPI assigned
- Mar 12, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 20
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ozarks Medical Center
Practice addresses (Care Compare)
1013 N College St
West Plains, MO 65775-3319
Phone (417) 505-7123
11 Pkwy Ctr
Ozarks Healthcare Sleep Center
West Plains, MO 65775
Phone 41725758596213
1100 N Kentucky Ave
West Plains, MO 65775-2029
1115 Alaska St
Suite 114
West Plains, MO 65775-2000
Phone (417) 257-6782
1210 N Kentucky Ave
Ozarks Healthcare Dermatology
West Plains, MO 65775-2030
Phone (417) 257-6734
1211 Porter Wagoner Blvd
Suite 23
West Plains, MO 65775-1826
Phone 41725767623010
1307 Porter Wagoner Blvd
Ozarks Healthcare Family Care
West Plains, MO 65775-1828
Phone (417) 255-8645
1627 Gibson Ave
West Plains, MO 65775-1873
Phone (417) 256-1838
1665 Gibson Ave
West Plains, MO 65775-1873
Phone (417) 257-5946
18 Pkwy Shopping Ctr
West Plains, MO 65775-1840
Phone (417) 256-1793
181 N Kentucky Ave
Ozarks Healthcare West Plains
West Plains, MO 65775-2092
Phone (417) 257-5972
312 N Kentucky Ave
Ozarks Healthcare Pediatrics
West Plains, MO 65775-2073
Phone (417) 257-7076
PO Box
Suite 1100
West Plains, MO 65775
Hospital & facility affiliations
- Ozarks Healthcare
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.96 of 100
- Quality
- 78.58
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 77.82
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200617000894 | MO | Practitioner - Family Practice | 4587938824 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Current |
Accepting new patients | |
| Ozarks Medical Center | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| St. Anthony'S Hospital Association | Past | Accepting new patients | |
| St. Anthony'S Hospital Association | Past | Accepting new patients | |
| University of Arkansas for Medical Sciences | Past | Accepting new patients |
Locations
1601 New Castle Rd
Forrest City, AR 72335
Phone (870) 261-0000
1309 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-1200
1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959
181 N Kentucky Ave
Ste 100
West Plains, MO 65775
Phone (417) 257-5911
Interoperability endpoints
- samuel.evans.1@14285.direct.athenahealth.com
- dr.evans@mhccaremail.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | C-8117 | AR | |
| Adult Medicine Physician | 207QA0505X | 2020012799 | MO | Yes |
Addresses
Primary practice location
181 N Kentucky Ave Ste 100
West Plains, MO 65775-2092
Mailing address
PO Box 1100
West Plains, MO 65775-1100
Phone (417) 256-9111
Other practice location 1
2 US Hwy 160
Caulfield, MO 65626
Phone (417) 942-6357
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200084697 | Medicaid | MO | |
| 2020012799 | Other | MO | STATE LICENSE |
Other providers in West Plains, MO
- Empower Therapy Services, LLC
- Empowerme Rehabilitation Missouri LLC
- Maria Eskandar
- Michael Eskew
- Ada R Evans
- Kimberley Faber
- Fairview R-XI School
- Family Counseling Center, Inc.
- Falyn Farmer
- Keturah Jolene Farmer
All providers in West Plains, MO · Adult Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.