NPIMap

Organization Active NPI

Evans Medical Clinic, PLLC

  • Primary Care Clinic/Center
  • Huntingdon, TN
National Provider Identifier
1598083982
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD31824 Issued in TN
Legal business name
EVANS MEDICAL CLINIC, PLLC
Practice address
3493 Veterans Dr N
Huntingdon, TN 38344-6227
Phone
(731) 986-2933
Fax
(731) 986-2938
NPI assigned
May 10, 2010
Last updated
Oct 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Dr. Thomas Paul Evans, MDNPI 1841285228
Title
Owner
Phone
(731) 986-2933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD31824 TN Primary

Addresses

Primary practice location

3493 Veterans Dr N
Huntingdon, TN 38344-6227

Mailing address

PO Box 465
Huntingdon, TN 38344-0465
Phone (731) 986-2933

Other identifiers 1

IdentifierTypeStateIssuer
1523966MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110124000757 TN Part B Supplier - Clinic/Group Practice 3870772817 Receives reassigned benefits from 7 practitioners
Practice locations: Huntingdon, TN

National Provider Directory

National Provider Directory

Locations

3493 Veterans Dr N
Huntingdon, TN 38344
Phone (731) 986-2933

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1598083982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 465",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383440465",
            "telephone_number": "731-986-2933",
            "fax_number": "731-986-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 VETERANS DR N",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383446227",
            "telephone_number": "731-986-2933",
            "fax_number": "731-986-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS MEDICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-986-2933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "MD31824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1523966",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.