Individual provider Active NPI

Sean Gregory Evans, PHARM D

  • Pharmacist
  • Charlestown, IN
National Provider Identifier
1538465778
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26023986A Issued in IN
Practice address
1250 Patrol Rd
Charlestown, IN 47111-8670
Phone
(855) 647-7379
NPI assigned
Feb 6, 2011
Last updated
Jun 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20573 NC
Pharmacist 183500000X PD15159 AR
Pharmacist 183500000X 26023986A IN Primary

Addresses

Primary practice location

1250 Patrol Rd
Charlestown, IN 47111-8670

Mailing address

7607 Hidden River Trce
Charlestown, IN 47111-8788
Phone (812) 569-6668

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD15159ARMDPharmacist
26023986AINMDPharmacist
20573NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Knipperx Inc. PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1296950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1538465778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 HIDDEN RIVER TRCE",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118788",
            "telephone_number": "812-569-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PATROL RD",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118670",
            "telephone_number": "855-647-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SEAN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-06",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "20573",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD15159",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26023986A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.