Individual provider Active NPI

Baylee M Evans, RD

  • Registered Dietitian
  • Glendale, AZ
National Provider Identifier
1487214292
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86114489 Issued in AZ
Practice address
18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone
(623) 399-6825
Fax
(623) 505-3474
NPI assigned
Jun 14, 2019
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86114489 AZ Primary

Addresses

Primary practice location

18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398

Mailing address

18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone (623) 399-6825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190725002227 AZ Practitioner - Registered Dietitian Or Nutrition Professional 7214263417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Am Nutrition ServicesGroup PAC ID 1254430580, 48 clinicians

Practice addresses (Care Compare)

18001 N 79TH Ave
Suite A12
Glendale, AZ 85308-8398
Phone (623) 399-6825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86114489AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Am Nutrition Services Dietitian, Registered CurrentSince Jun 10, 2019 Accepting new patients

Locations

10750 W McDowell Rd
Ste A300
Avondale, AZ 85392
Phone (623) 882-0925

10825 W McDowell Rd
Ste 220
Avondale, AZ 85392
Phone (623) 748-1291

18001 N 79th Ave
Ste A12
Glendale, AZ 85308
Phone (623) 321-5380

10000 N 31st Ave
Ste D205
Phoenix, AZ 85051

3815 E Bell Rd
Ste 4250
Phoenix, AZ 85032
Phone (602) 750-0156

4653 E Cotton Gin Loop
Ste 100
Phoenix, AZ 85040

10752 N 89th Pl
Ste 114B
Scottsdale, AZ 85260
Phone (480) 553-9333

Organizations & group practices 1

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1487214292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BAYLEE",
        "middle_name": "M",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86114489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.