Active NPI
Quinnmeshia Evans
- Prosthetist
- Goshen, IN
National Provider Identifier
1508699711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- BC22400817
- Practice address
- 2606 Peddlers Village Rd Ste 218
Goshen, IN 46526-1004 - Phone
- (574) 326-9166
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | BC22400817 | IN | Primary |
Addresses
Primary practice location
2606 Peddlers Village Rd Ste 218
Goshen, IN 46526-1004
Mailing address
72352 Amber Dr
Milford, IL 46542-9534
Phone (574) 326-9166
Other practice location 1
2606 Peddlers Village Rd Ste 218
Goshen, IN 46526-1004
Phone (574) 326-9166
Other practice location 2
2606 Peddlers Village Rd Ste 218
Goshen, IN 46526-1004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BC22400817 | IN | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1508699711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72352 AMBER DR",
"city": "MILFORD",
"state": "IL",
"postal_code": "465429534",
"telephone_number": "574-326-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2606 PEDDLERS VILLAGE RD STE 218",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465261004",
"telephone_number": "574-326-9166"
}
],
"practiceLocations": [
{
"address_1": "2606 Peddlers Village Rd Ste 218",
"address_purpose": "LOCATION",
"city": "Goshen",
"state": "IN",
"postal_code": "465261004",
"country_code": "US",
"telephone_number": "574-326-9166",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2606 Peddlers Village Rd Ste 218",
"address_purpose": "LOCATION",
"city": "Goshen",
"state": "IN",
"postal_code": "465261004",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "QUINNMESHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2024-08-22",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "IN",
"license": "BC22400817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.