Organization Active NPI

Greg T. Evans DPM PC

  • Foot Surgery Podiatrist
  • Wyoming, PA
National Provider Identifier
1619164415
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
SC003363L Issued in PA
Legal business name
GREG T. EVANS DPM PC
Practice address
908 Wyoming Ave Ste C
Wyoming, PA 18644-1300
Phone
(570) 288-3677
Fax
(570) 489-4583
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Greg Evans, DPM
Title
Podiatrist
Phone
(570) 288-3677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X SC003363L PA Primary

Addresses

Primary practice location

908 Wyoming Ave Ste C
Wyoming, PA 18644-1300

Mailing address

908 Wyoming Ave Ste C
Wyoming, PA 18644-1300
Phone (570) 288-3677

National Provider Directory

National Provider Directory

Locations

908 Wyoming Ave
Ste C
Wyoming, PA 18644
Phone (570) 288-3677

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1619164415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 WYOMING AVE STE C",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441300",
            "telephone_number": "570-288-3677",
            "fax_number": "570-489-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 WYOMING AVE STE C",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441300",
            "telephone_number": "570-288-3677",
            "fax_number": "570-489-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREG T. EVANS DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "570-288-3677",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC003363L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, PA

Sources for this page

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