Individual provider Active NPI

Jeanine Evans, APRN

  • Family Nurse Practitioner
  • Cadiz, KY
National Provider Identifier
1447520853
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007256 Issued in KY
Practice address
214 Main St
Cadiz, KY 42211-9153
Phone
(270) 522-0898
Fax
(270) 522-5636
NPI assigned
Jan 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 3007256 KY
Family Nurse Practitioner 363LF0000X 3007256 KY Primary

Addresses

Primary practice location

214 Main St
Cadiz, KY 42211-9153

Mailing address

214 Main St
Cadiz, KY 42211-9153
Phone (270) 522-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120306000607 KY Practitioner - Certified Clinical Nurse Specialist (CNS) 1759540065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trigg County Hospital, IncGroup PAC ID 5193620805, 33 clinicians

Practice addresses (Care Compare)

214 Main St
Cadiz, KY 42211-9153
Phone (270) 522-0898

254 Main St
Cadiz, KY 42211-9153
Phone (270) 522-3215

Hospital & facility affiliations

  • Caretenders Home health agency, Cadiz, KY, CCN 187159
  • Lifeline Home Health of Western Kentucky Home health agency, Hopkinsville, KY, CCN 187300
  • Trigg County Hospital Hospital, Cadiz, KY, CCN 181304
  • Jennie Stuart Medical Center Hospital, Hopkinsville, KY, CCN 180051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3007256KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trigg County Hospital, Inc CurrentSince Oct 28, 2016 Accepting new patients
Trigg County Hospital, Inc CurrentSince Oct 28, 2016 Accepting new patients

Locations

214 Main St
Cadiz, KY 42211
Phone (270) 522-0898

250 Main St
Ste B
Cadiz, KY 42211

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

Interoperability endpoints

  • Direct secure messaging: jeanine.evans@tcpc.eclinicaldirectplus.com

Organizations & group practices 2

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 4

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": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1447520853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 MAIN ST",
            "city": "CADIZ",
            "state": "KY",
            "postal_code": "422119153",
            "telephone_number": "270-522-0898",
            "fax_number": "270-522-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MAIN ST",
            "city": "CADIZ",
            "state": "KY",
            "postal_code": "422119153",
            "telephone_number": "270-522-0898",
            "fax_number": "270-522-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JEANINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KY",
            "license": "3007256",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadiz, KY

Sources for this page

Verify at the official NPI Registry.