Charles Evans III, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA69049 Issued in NJ

Practice address

755 Memorial Pkwy
Suite 115
Phillipsburg, NJ 08865-2748

Phone

(908) 454-3737

Fax

(908) 454-0402

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: charles.evans@slpg.direct-sluhn.org

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.

• St. Luke'S Physician Group, Inc.

  • Maternal & Fetal Medicine Physician
  • Fountain Hill, PA
  • NPI 1003867623
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1669432472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRASS CASTLE RD",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "078824327",
            "telephone_number": "908-835-1910",
            "fax_number": "908-835-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY",
            "address_2": "SUITE 115",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "908-454-3737",
            "fax_number": "908-454-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "CHARLES",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA69049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8353107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Essential Health LLC
• Essgee Phillipsburg Corp (Phillipsburg Pharmacy)
• Essgee Phillipsburg Corp (Phillipsburg Pharmacy)
• Taheera Eutsey, MSW
• Jacqueline D. Evanko
• Eye Care of Practice Associates
• Ebere N Ezeanya, M.D.
• Family Guidance Center of Warren County
• Family Guidance Center of Warren County
• Rebecca Fang

• Pediatrics Physician in Phillipsburg, NJ
• Providers in Phillipsburg, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.