Individual provider Active NPI

Evan J Madden, MD

  • Family Medicine Physician
  • Greenwood, SC
National Provider Identifier
1487181210
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40894 Issued in SC
Practice address
1325 Spring St
Greenwood, SC 29646-3860
Phone
(864) 725-4272
Fax
(864) 725-4452
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 202301220 NC
Family Medicine Physician 207Q00000X 40894 SC Primary

Addresses

Primary practice location

1325 Spring St
Greenwood, SC 29646-3860

Mailing address

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4272

Other practice location 1

1210 New Garden Rd
Greensboro, NC 27410-2721
Phone (336) 294-6190

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address emadden170160@selfregional.direct-ci.net
Direct Messaging Address Evan.Madden@eaglep.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20180606000047 SC Practitioner - Family Practice 3870858228 Reassigns benefits to 1 organization
I20231107001842 NC Practitioner - Family Practice 3870858228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1210 New Garden Rd
Greensboro, NC 27410-2721
Phone (336) 294-6190

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40894SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Jul 1, 2018 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Oct 2, 2023 Accepting new patients
Self Medical Group Current Accepting new patients
Eagle Physicians and Associates PA Family Medicine CurrentSince Oct 2, 2023 Accepting new patients
Self Medical Group CurrentSince Jul 1, 2018 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

324 W Wendover Ave
Ste 200
Greensboro, NC 27408
Phone (336) 274-6515

300 Ridge Medical Plaza Rd
Edgefield, SC 29824
Phone (803) 637-3174

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: evan.madden@eaglep.eclinicaldirectplus.com
  • Direct secure messaging: emadden170160@selfregional.direct-ci.net

Organizations & group practices 8

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 2

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1487181210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4272",
            "fax_number": "864-725-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4272",
            "fax_number": "864-725-4452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 New Garden Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274102721",
            "country_code": "US",
            "telephone_number": "336-294-6190",
            "fax_number": "336-294-6278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDEN",
        "first_name": "EVAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "202301220",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "40894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emadden170160@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "1325 Spring St",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Evan.Madden@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1210 New Garden Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.