Jessica L Evans, NP
Individual provider Active NPI Family Nurse Practitioner · Fredonia, KS
NPI 1487969192 · NPPES record last updated Aug 18, 2010
Key facts
- NPI
- 1487969192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 53-75168-072 (KS)
- Practice address
- 1525 Madison St Ste 2
Fredonia, KS 66736-1704 - Phone
- (620) 378-2068
- Fax
- (620) 378-2312
- NPI assigned
- Aug 18, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Advanced Healthcare Associates, LLC
Practice addresses (Care Compare)
928 N 3Rd St
Fredonia, KS 66736-2166
Phone (620) 288-1030
Hospital & facility affiliations
- Home Town Health Care
- Fredonia Regional Hospital
- Wilson Medical Center
- Neosho Memorial Regional Medical Center
- Labette Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101022000552 | KS | Practitioner - Nurse Practitioner | 3870786866 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-75168-072 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fredonia Regional Hospital | Current |
Accepting new patients | |
| Advanced Healthcare Associates, LLC | Family | Current |
Accepting new patients |
| Fredonia Regional Hospital | Current |
Accepting new patients |
Locations
1525 Madison St
Fredonia, KS 66736
Phone (620) 378-3341
1525 Madison St
Ste 2
Fredonia, KS 66736
Phone (620) 378-2068
928 N 3rd St
Fredonia, KS 66736
Phone (620) 288-1030
1527 Madison St
Fredonia, KS 66736
Phone (316) 378-2121
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/0153994b-73fd-40ca-acc3-d43bb5781a7b/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53-75168-072 | KS | Yes |
Addresses
Primary practice location
1525 Madison St Ste 2
Fredonia, KS 66736-1704
Mailing address
1525 Madison St Ste 2
Fredonia, KS 66736-1704
Phone (620) 378-2068
Other providers in Fredonia, KS
- County of Wilson
- CPF Senior Living - Fredonia LLC
- DRS. Morris & Hill Medical Clinic, LLC
- Jacob Dugan
- Holly Dyrud
- Fredonia Pharmacy Inc
- Fredonia Pharmacy Inc
- Fredonia Regional Hospital
- Fredonia Regional Hospital
- Fredonia Regional Hospital
All providers in Fredonia, KS · Family Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.