Active NPI
Mary Lee Evers, PHD
- Clinical Psychologist
- Roanoke Rapids, NC
National Provider Identifier
1447469804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1410
- Practice address
- 2064 NC Highway 125
Roanoke Rapids, NC 27870-9436 - Phone
- (252) 536-5000
- Fax
- (252) 536-2258
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 1410 | NC | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1410 | NC | |
| Health Psychologist | 103TH0004X | 1410 | NC | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 1410 | NC | |
| Clinical Psychologist | 103TC0700X | 1410 | NC | Primary |
Addresses
Primary practice location
2064 NC Highway 125
Roanoke Rapids, NC 27870-9436
Mailing address
PO Box 640
Roanoke Rapids, NC 27870-0640
Phone (252) 536-5440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0345A | Other | NC | NC BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1410 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549497600000",
"number": "1447469804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278700640",
"telephone_number": "252-536-5440",
"fax_number": "252-536-5444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2064 NC HIGHWAY 125",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278709436",
"telephone_number": "252-536-5000",
"fax_number": "252-536-2258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERS",
"first_name": "MARY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2019-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NC",
"license": "1410",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NC",
"license": "1410",
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "NC",
"license": "1410",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "NC",
"license": "1410",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BCBS",
"identifier": "0345A",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke Rapids, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.