NPIMap

Organization Active NPI

Evan P Provisor MD PC

  • Surgery Physician
  • Sharon, CT
National Provider Identifier
1497732101
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
EVAN P PROVISOR MD PC
Practice address
29 Hospital Hill Rd
Suite 1600
Sharon, CT 06069-2095
Phone
(860) 364-0226
Fax
(860) 364-0875
NPI assigned
Dec 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Authorized official

Name
Evan Paul Provisor, MDNPI 1366427429
Title
President
Phone
(860) 364-0226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X CT Primary

Addresses

Primary practice location

29 Hospital Hill Rd
Suite 1600
Sharon, CT 06069-2095

Mailing address

PO Box 786
Sharon, CT 06069-0786
Phone (860) 364-0226

Other names 1

  • Sharon Surgical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1497732101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 786",
            "city": "SHARON",
            "state": "CT",
            "postal_code": "060690786",
            "telephone_number": "860-364-0226",
            "fax_number": "860-364-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL HILL RD",
            "address_2": "SUITE 1600",
            "city": "SHARON",
            "state": "CT",
            "postal_code": "060692095",
            "telephone_number": "860-364-0226",
            "fax_number": "860-364-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN P PROVISOR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "PROVISOR",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-364-0226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharon Surgical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sharon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.