Individual provider Active NPI

Barbara Evans

  • Adult Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1518359645
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
871787 Issued in TX
Practice address
1001 12TH Ave Ste 130
Fort Worth, TX 76104-3926
Phone
(817) 870-2637
Fax
(817) 529-2640
NPI assigned
Feb 26, 2015
Last updated
Oct 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 871787 TX Primary

Addresses

Primary practice location

1001 12TH Ave Ste 130
Fort Worth, TX 76104-3926

Mailing address

1001 12TH Ave Ste 130
Fort Worth, TX 76104-3926
Phone (817) 870-2637

Other identifiers 1

IdentifierTypeStateIssuer
344032301MedicaidTX

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
871787TXMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1518359645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-870-2637",
            "fax_number": "817-529-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-870-2637",
            "fax_number": "817-529-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BARBARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "871787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344032301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.