Individual provider Active NPI

William A Evans, AGACNP-BC

  • Adult Health Nurse Practitioner
  • Athens, GA
National Provider Identifier
1568035681
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN275424 Issued in GA
Practice address
2142 W Broad St BLDG 100 Ste 200
Athens, GA 30606-3509
Phone
(706) 548-6881
Fax
(706) 546-0821
NPI assigned
Jul 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN275424 GA
Adult Health Nurse Practitioner 363LA2200X RN275424 GA Primary

Addresses

Primary practice location

2142 W Broad St BLDG 100 Ste 200
Athens, GA 30606-3509

Mailing address

PO Box 48089
Athens, GA 30604-8089
Phone (706) 389-3727

Other practice location 1

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 389-3410

Other identifiers 2

IdentifierTypeStateIssuer
2021040471OtherANCC CERTIFICATION NUMBER
RN275424OtherGAAPRN LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018000519 GA Practitioner - Nurse Practitioner 4385042613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Mary's Medical Group, Inc.Group PAC ID 7113098393, 118 clinicians

Practice addresses (Care Compare)

2142 W Broad St
BLDG 100 Suite 200
Athens, GA 30606-3509
Phone (706) 548-6881

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN275424GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, Inc Current Accepting new patients
St. Mary's Medical Group, Inc. CurrentSince Jul 3, 2023 Accepting new patients
St. Mary's Medical Group, Inc. CurrentSince Jul 3, 2023 Accepting new patients

Locations

1061 Dowdy Rd
Ste 103
Athens, GA 30606
Phone (706) 543-9222

740 Prince Ave
Ste 2
Athens, GA 30606
Phone (706) 548-5488

2142 W Broad St
Bldg 200
Athens, GA 30606
Phone (706) 548-6881

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

2142 W Broad St
Bldg 100
Athens, GA 30606
Phone (706) 548-6881

1110 Commerce Dr
Ste 108
Greensboro, GA 30642
Phone (706) 310-1859

355 Clear Creek Pkwy
Ste 2004
Lavonia, GA 30553
Phone (706) 356-0554

868 Michael Etchison Rd
#B
Monroe, GA 30655
Phone (706) 389-3440

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7598/brand/1/csg/1/fhir/r4
  • Direct secure messaging: wevans2020307@direct.trinity-health.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1568035681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48089",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306048089",
            "telephone_number": "706-389-3727",
            "fax_number": "706-389-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 W BROAD ST BLDG 100 STE 200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063509",
            "telephone_number": "706-548-6881",
            "fax_number": "706-546-0821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 Baxter St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306063712",
            "country_code": "US",
            "telephone_number": "706-389-3410",
            "fax_number": "706-389-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN275424",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN275424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATION NUMBER",
            "identifier": "2021040471",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "RN275424",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.