Active NPI
Evan Kohoutek, RN
- Community Health Registered Nurse
- Richmond Hill, GA
National Provider Identifier
1679957666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- N-43979
- Practice address
- 145 Ohara Dr
Richmond Hill, GA 31324-7619 - Phone
- (208) 262-1263
- NPI assigned
- Jul 20, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | N-43979 | ID | Primary |
Addresses
Primary practice location
145 Ohara Dr
Richmond Hill, GA 31324-7619
Mailing address
145 Ohara Dr
Richmond Hill, GA 31324-7619
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-43979 | ID | MD | Community Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437350400000",
"number": "1679957666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 OHARA DR",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313247619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 OHARA DR",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313247619",
"telephone_number": "208-262-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHOUTEK",
"first_name": "EVAN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-20",
"last_updated": "2015-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "ID",
"license": "N-43979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.