Laura A. Evans, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.006273 Issued in IL

Practice address

804 State St
#5
Quincy, IL 62301-4968

Phone

(217) 224-1750

Fax

(214) 224-0403

NPI assigned

Jan 15, 2013

Last updated

Jan 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Athletic and Therapeutic Institute of Bourbonnais, LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, IL
  • NPI 1124766696
  NPD (past)

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1518204239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 STATE ST",
            "address_2": "#5",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014968",
            "telephone_number": "217-224-1750",
            "fax_number": "214-224-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 STATE ST",
            "address_2": "#5",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014968",
            "telephone_number": "217-224-1750",
            "fax_number": "214-224-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LAURA",
        "middle_name": "A.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.006273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Eslick, APNP
• Edward David Esselman, MS LCPC
• Rajesh Kannan Ethiraj, M.D.,
• Dan H Evans, M.D.
• David Steven Evans, CADC
• Regan R Ewert, RN
• Eye MDS of Quincy SC
• Annslee Fahy, FCS-DIETETICS
• Fairview Heights Medical Group SC (Pediatric Cardiology of Illinois)
• Darius Faison

• Physical Therapy Assistant in Quincy, IL
• Providers in Quincy, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.