Individual provider Active NPI

Evan W Horner

  • Specialist
  • Quincy, IL
National Provider Identifier
1598982415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
4700 Broadway St
Quincy, IL 62305-9112
Phone
(217) 222-2529
Fax
(217) 222-2895
NPI assigned
Apr 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

4700 Broadway St
Quincy, IL 62305-9112

Mailing address

4700 Broadway St
Quincy, IL 62305-9112
Phone (217) 222-2529

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

State licenses

LicenseStateTypeSpecialty
166.000608ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Family Counseling, LLC Past Accepting new patients
Madison Park Christian Church Past Accepting new patients

Organizations & group practices 2

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598982415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059112",
            "telephone_number": "217-222-2529",
            "fax_number": "217-222-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059112",
            "telephone_number": "217-222-2529",
            "fax_number": "217-222-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNER",
        "first_name": "EVAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.