Individual provider Active NPI

Evangeline Stearns, PT, DPT

  • Physical Therapist
  • Fort Defiance, AZ
National Provider Identifier
1609508050
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
32420 Issued in AZ
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649
Phone
(928) 729-8000
NPI assigned
Jun 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32420 AZ Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230801000785 NM Practitioner - Physical Therapist in Private Practice 9830572684 Reassigns benefits to 1 organization
I20231123000080 TX Practitioner - Physical Therapist in Private Practice 9830572684 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32420AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Care, LLC Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Nov 6, 2023 Accepting new patients

Locations

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

834 Paseo del Pueblo Sur
Taos, NM 87571
Phone (575) 418-6787

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1609508050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEARNS",
        "first_name": "EVANGELINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-25",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "32420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.