Individual provider Active NPI

Evangelyn C Okereke, M.D.

  • Pediatric Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1689808339
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
S0965 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-4054
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD-54421 IA
Pediatric Anesthesiology Physician 207LP3000X 13146 WI
Anesthesiology Physician 207L00000X 13146 WI
Pediatric Anesthesiology Physician 207LP3000X S0965 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860

Other practice location 1

Marshfield Clinic
1000 N Oak Avenue
Marshfield, WI 54449-5703
Phone (715) 221-5511

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com
Direct Messaging Address eokereke137397@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, LA, TX, IA, MI5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20130724000756 WI Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 1153562772 Reassigns benefits to 9 organizations
I20170216002649 LA Practitioner - Anesthesiology 1153562772 Reassigns benefits to 1 organization
I20191202000530 TX Practitioner - Anesthesiology 1153562772 Reassigns benefits to 1 organization
I20250825002885 IA Practitioner - Anesthesiology 1153562772 Reassigns benefits to 1 organization
I20260620000237 MI Practitioner - Anesthesiology 1153562772

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-3121

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S0965TXMDPediatric Anesthesiology Physician
13146WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology Current Accepting new patients
Cook Children'S Physician Network CurrentSince Jan 2, 2020 Accepting new patients
MCHS Hospitals Inc Anesthesiology Current Accepting new patients
Flambeau Hospital Inc CurrentSince Mar 31, 2025 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 18, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Mar 31, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Mar 31, 2025 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 18, 2025 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Mar 31, 2025 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Anesthesiology CurrentSince Mar 1, 2017 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 31, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Mar 31, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 31, 2025 Accepting new patients
Cook Children'S Physician Network CurrentSince Jan 2, 2020 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Mar 31, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Mar 31, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Mar 31, 2025 Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

1501 Kings Hwy
Rm 1201
Shreveport, LA 71103
Phone (318) 675-4881

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

4100 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: eokereke137397@cookchildrens.direct-ci.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1689808339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-4054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Marshfield Clinic",
            "address_2": "1000 N Oak Avenue",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-221-5511",
            "fax_number": "715-389-0626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKEREKE",
        "first_name": "EVANGELYN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "MD-54421",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "WI",
            "license": "13146",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "13146",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "S0965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "Marshfield Clinic",
            "address_2": "1000 N Oak Avenue",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eokereke137397@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.