Individual provider Active NPI

Jennifer Evan, MD

  • Neurology Physician
  • Valparaiso, IN
National Provider Identifier
1487018479
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01084951A Issued in IN
Practice address
1501 Meadowglen Dr
Valparaiso, IN 46383-0736
Phone
(219) 309-1160
Fax
(219) 209-5502
NPI assigned
Apr 6, 2016
Last updated
May 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0063772 CO
Neurology Physician 2084N0400X 01084951A IN Primary

Addresses

Primary practice location

1501 Meadowglen Dr
Valparaiso, IN 46383-0736

Mailing address

1501 Meadowglen Dr
Valparaiso, IN 46383-0736
Phone (219) 309-1160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200618001203 CO Practitioner - Pain ManagementPractitioner - Neurology 1658662515 Reassigns benefits to 1 organization
I20200825002786 IN Practitioner - Neurology 1658662515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0063772COMDNeurology Physician
01084951AINMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jul 1, 2020 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 1, 2020 Accepting new patients
Centers for Neurological Diseases, PC Neurology CurrentSince Dec 1, 2020 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

10260 191st St
Ste 100
Mokena, IL 60448
Phone (708) 425-1907

521 E 86th Ave
Ste Z
Merrillville, IN 46410
Phone (219) 769-0777

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1487018479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MEADOWGLEN DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463830736",
            "telephone_number": "219-309-1160",
            "fax_number": "219-209-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MEADOWGLEN DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463830736",
            "telephone_number": "219-309-1160",
            "fax_number": "219-209-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVAN",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0063772",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01084951A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.