Active NPI
Lori Jo Evans, PA-C
- Physician Assistant
- Winter Park, FL
National Provider Identifier
1659453439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9106376
- Practice address
- 2005 Mizell Ave Ste 2100
Winter Park, FL 32792-4126 - Phone
- (407) 599-6460
- Fax
- (407) 599-6461
- NPI assigned
- Oct 20, 2006
- Last updated
- Mar 22, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50-002502 | OH | |
| Physician Assistant | 363A00000X | PA9106376 | FL | Primary |
Addresses
Primary practice location
2005 Mizell Ave Ste 2100
Winter Park, FL 32792-4126
Mailing address
2005 Mizell Ave Ste 2100
Winter Park, FL 32792-4126
Phone (407) 599-6460
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11907432 | Other | OH | CAQH |
| 0156040 | Medicaid | OH |
Other names 1
- Lori J O'Brien
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Baylor College of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50-002502 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Physician Assistant | Current | Accepting new patients |
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Ohio Gastroenterology Group, Inc. | Past | Accepting new patients | |
| Hospitalist Medicine Physicians of Franklin County, LTD | Past | Accepting new patients | |
| Henry Anesthesia Associates LLC | Past | Accepting new patients |
Locations
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
2005 Mizell Ave
Ste 2100
Winter Park, FL 32792
Phone (407) 303-4190
Organizations & group practices 5
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.
-
dba AdventHealth Medical Group
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
Physician Assistant
-
dba Rothman Orthopaedics AdventHealth Medical Group at Minneola
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- Anesthesiology Physician
- Stockbridge, GA
- NPI 1447229943
-
- Internal Medicine Physician
- Columbus, OH
- NPI 1326088782
-
- Gastroenterology Physician
- Columbus, OH
- NPI 1124197637
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Orlando
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
dba AdventHealth Orlando Outreach Laboratory
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1659453439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 MIZELL AVE STE 2100",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924126",
"telephone_number": "407-599-6460",
"fax_number": "407-599-6461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 MIZELL AVE STE 2100",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924126",
"telephone_number": "407-599-6460",
"fax_number": "407-599-6461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "LORI",
"middle_name": "JO",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50-002502",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9106376",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11907432",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0156040",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LORI",
"last_name": "O'BRIEN",
"middle_name": "J",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.