Mark Kendal Evans, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4512 Issued in OH

Practice address

2650 Madison Rd
Cincinnati, OH 45208-1332

Phone

(513) 772-9300

Fax

(513) 772-9302

NPI assigned

Apr 12, 2007

Last updated

Jan 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Success Consortium IncGroup PAC ID 3375585813, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Family Success Consortium Inc

  • Psychologist
  • Cincinnati, OH
  • NPI 1942520648
  Medicare reassignment Care Compare group NPD Authorized official
• Family Success Consortium Inc

  • Psychologist
  • Cincinnati, OH
  • NPI 1275724916

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1437373487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081332",
            "telephone_number": "513-772-9300",
            "fax_number": "513-772-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081332",
            "telephone_number": "513-772-9300",
            "fax_number": "513-772-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARK",
        "middle_name": "KENDAL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4512",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "825",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0897918",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin L Evans
• Latoya Dashanda Evans
• Lerrien Evans
• Linda C Evans, MD
• Lisa Ann Evans
• Melanie Danielle Evans, PNHNP
• Meredith A Evans, PMHNP-BC
• Miracle A Evans
• Mykasha Evans
• Namaria Evans

• Clinical Psychologist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.