Individual provider Active NPI

Jessica L Evans, NP

  • Family Nurse Practitioner
  • Fredonia, KS
National Provider Identifier
1487969192
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-75168-072 Issued in 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
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-75168-072 KS Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20101022000552 KS Practitioner - Nurse Practitioner 3870786866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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, LLCGroup PAC ID 0547646614, 4 clinicians

Practice addresses (Care Compare)

928 N 3Rd St
Fredonia, KS 66736-2166
Phone (620) 288-1030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-75168-072KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Healthcare Associates, LLC Family CurrentSince Oct 8, 2022 Accepting new patients
Fredonia Regional Hospital CurrentSince Jan 25, 2011 Accepting new patients
Fredonia Regional Hospital CurrentSince Jan 25, 2011 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

1527 Madison St
Fredonia, KS 66736
Phone (316) 378-2121

928 N 3rd St
Fredonia, KS 66736
Phone (620) 288-1030

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0153994b-73fd-40ca-acc3-d43bb5781a7b/

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.

Hospital & facility affiliations 7

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": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1487969192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 MADISON ST STE 2",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361704",
            "telephone_number": "620-378-2068",
            "fax_number": "620-378-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 MADISON ST STE 2",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361704",
            "telephone_number": "620-378-2068",
            "fax_number": "620-378-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-75168-072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredonia, KS

Sources for this page

Verify at the official NPI Registry.