Active NPI
Cody J Evans, M.D.
- Child & Adolescent Psychiatry Physician
- Portland, OR
National Provider Identifier
1649484155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD28394
- Practice address
- 2651 NW Thurman St
Suite 101
Portland, OR 97210-2326 - Phone
- (503) 954-2403
- Fax
- (503) 946-1156
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD28394 | OR | Primary |
| Psychiatry Physician | 2084P0800X | MD28394 | OR |
Addresses
Primary practice location
2651 NW Thurman St
Suite 101
Portland, OR 97210-2326
Mailing address
2651 NW Thurman St
Suite 101
Portland, OR 97210-2326
Phone (503) 954-2403
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 16, 2019 through Sep 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Firstcare Medical Foundation | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452643200000",
"number": "1649484155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2651 NW THURMAN ST",
"address_2": "SUITE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102326",
"telephone_number": "503-954-2403",
"fax_number": "503-946-1156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2651 NW THURMAN ST",
"address_2": "SUITE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102326",
"telephone_number": "503-954-2403",
"fax_number": "503-946-1156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "CODY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2016-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OR",
"license": "MD28394",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD28394",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.