Sr Evans Jr., MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

04978 Issued in MS

Practice address

1604 Leflore Ave
Greenwood, MS 38930

Phone

(662) 453-0532

Fax

(662) 453-3079

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Mississippi School of Medicine, 1964

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenwood Leflore HospitalGroup PAC ID 1153399472, 16 clinicians

Greenwood Leflore HospitalGroup PAC ID 8123096880, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099
• Greenwood Leflore Hospital Nursing home, CCN 25U099

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Medicare reassignment Care Compare group NPD
• Greenwood Leflore Hospital

  • Hospitalist Physician
  • Greenwood, MS
  • NPI 1720048440
  Medicare reassignment Care Compare group
• Central Mississippi Radiology

  • Specialist
  • Greenwood, MS
  • NPI 1275725590
  NPD
• Sunder Jagwani MD PA

  • Body Imaging Physician
  • Greenwood, MS
  • NPI 1033318985
  NPD
• Greenwood Leflore Hospital

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1578595302
  NPD (past)
• Greenwood Leflore Hospital

  • Gastroenterology Physician
  • Greenwood, MS
  • NPI 1689633950
  NPD (past)

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

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Care Compare affiliation

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1598847253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 LEFLORE AVE",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-453-0532",
            "fax_number": "662-453-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 LEFLORE AVE",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-453-0532",
            "fax_number": "662-453-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SR",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MS",
            "license": "04978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125971",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020052768",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chandra Ellis
• EMS Clinic
• Kathryn Flanagan Evans, FNP-C
• Yalander Yavette Everett
• Kathryn Sloane Fair, DPT
• Faith Works Home Care Services
• Family Dental Associates PLLC
• Monica Yvette Felston Williams

• Gynecology Physician in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Gynecology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.