Evangeleine Helene Bates, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Athens, AL
NPI 1508216649 · NPPES record last updated Jan 9, 2024
Key facts
- NPI
- 1508216649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1-140136 (AL)
- Practice address
- 111 S Marion St Ste B
Athens, AL 35611-2552 - Phone
- (256) 230-5280
- NPI assigned
- Jun 20, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aderholt Medical LLC
Practice addresses (Care Compare)
111 S Marion St
Suite B
Athens, AL 35611-2552
Phone (256) 230-5280
Hospital & facility affiliations
- Madison Home Health Services, LLC
- Centerwell Home Health
- Amedisys Home Health of Huntsville
- Athens-Limestone Homecare
- Aveanna Home Health
- Athens Limestone Hospital
- Huntsville Hospital
- North Alabama Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL, TN
- 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 |
|---|---|---|---|---|
| I20161013001835 | AL | Practitioner - Nurse Practitioner | 4587952130 | Reassigns benefits to 2 organizations |
| I20170103001764 | TN | Practitioner - Nurse Practitioner | 4587952130 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-140136 | AL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Aderholt Medical, LLC | Current |
Accepting new patients | |
| Athens-Limestone ER Physicians | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients |
Locations
1207 E Forrest St
Ste 204D
Athens, AL 35613
Phone (256) 230-5280
700 W Market St
Athens, AL 35611
Phone (256) 233-9292
111 S Marion St
Athens, AL 35611
Phone (256) 230-5280
111 S Marion St
Ste B
Athens, AL 35611
Phone (256) 230-5280
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 1-140136 | AL | |
| Family Nurse Practitioner | 363LF0000X | 1-140136 | AL | Yes |
Addresses
Primary practice location
111 S Marion St Ste B
Athens, AL 35611-2552
Mailing address
180 N Dabney LN
Rogersville, AL 35652-6205
Phone (916) 549-1965
Other practice location 1
700 W Market St
Athens, AL 35611-2457
Phone (256) 233-9292
Other providers in Athens, AL
- Darius Steven Barry
- Charmine Kay Arbolente Bartlett
- Loren Pierce Batchelor
- Connie Y Bates
- Denise Sherie Bates
- Eduardo Javier Bazan Lavanda
- BCL Foundation, Inc
- Robert Brad Beasley
- William Edward Beasley Jr.
- Bechert, LLC Dba Lang Chiropractic Center
All providers in Athens, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2024. 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.