Active NPI
Susan Evans, NP
- Nurse Practitioner
- Clovis, CA
National Provider Identifier
1669584033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 7286
- Practice address
- 255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861 - Phone
- (559) 297-1300
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 7286 | CA | Primary |
Addresses
Primary practice location
255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861
Mailing address
255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861
Phone (559) 297-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 456373 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7286 | CA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235606400000",
"number": "1669584033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W BULLARD AVE",
"address_2": "SUITE 124",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120861",
"telephone_number": "559-297-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 W BULLARD AVE",
"address_2": "SUITE 124",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120861",
"telephone_number": "559-297-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SUSAN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2009-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "7286",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "456373",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.