Individual provider Active NPI

Eric E Evans, PA-C

  • Physician Assistant
  • Greenville, NC
National Provider Identifier
1407808314
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00806 Issued in NC
Practice address
150 E Arlington Blvd
Suite E
Greenville, NC 27858
Phone
(252) 695-0269
Fax
(252) 413-0526
NPI assigned
May 17, 2006
Last updated
Aug 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00806 NC Primary
Medical Physician Assistant 363AM0700X 0010-00806 NC
Medical Physician Assistant 363AM0700X 0110001530 VA

Addresses

Primary practice location

150 E Arlington Blvd
Suite E
Greenville, NC 27858

Mailing address

150 E Arlington Blvd
Suite E
Greenville, NC 27858-5019
Phone (252) 695-0269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20070609000127 NC Practitioner - Physician Assistant 4082712336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1110 SE Cary Pkwy
Suite 207
Cary, NC 27518-7420

2736 W Arlington Blvd
Apt 104
Greenville, NC 27834-4129

309 N William St
Goldsboro, NC 27530-3705

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-00806NCMDPhysician Assistant
0110001530VAMDMedical Physician Assistant

Organizations & group practices 1

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 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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1407808314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E ARLINGTON BLVD",
            "address_2": "SUITE E",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585019",
            "telephone_number": "252-695-0269",
            "fax_number": "252-413-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E ARLINGTON BLVD",
            "address_2": "SUITE E",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-695-0269",
            "fax_number": "252-413-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ERIC",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00806",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-00806",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.