Individual provider Active NPI

Carol Jane Evers, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1629077607
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R9C37 Issued in MO
Practice address
40 N Florissant Rd
Saint Louis, MO 63135-2332
Phone
(314) 521-1302
NPI assigned
Jul 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R9C37 MO Primary

Addresses

Primary practice location

40 N Florissant Rd
Saint Louis, MO 63135-2332

Mailing address

40 N Florissant Rd
Saint Louis, MO 63135-2332
Phone (314) 521-1302

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080505000391 MO Practitioner - Internal Medicine 3274612122 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R9C37MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients

Locations

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1120 Shackelford Rd
Florissant, MO 63031
Phone (314) 830-5805

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Organizations & group practices 3

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1629077607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N FLORISSANT RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631352332",
            "telephone_number": "314-521-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N FLORISSANT RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631352332",
            "telephone_number": "314-521-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERS",
        "first_name": "CAROL",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R9C37",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.