Individual provider Active NPI

Jennifer Elizabeth Evans, PA-C

  • Physician Assistant
  • Chester, PA
National Provider Identifier
1689942690
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057568 Issued in PA
Practice address
30 Medical Center Blvd Ste 305
Chester, PA 19013
Phone
(610) 874-6448
Fax
(610) 876-7399
NPI assigned
Dec 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA057568 PA Primary

Addresses

Primary practice location

30 Medical Center Blvd Ste 305
Chester, PA 19013

Mailing address

300 Lawrence Rd
Broomall, PA 19008-3220
Phone (570) 947-2123

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (706) 766-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171130002788 PA Practitioner - Physician Assistant 7517126410 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Jan 1, 2023 Accepting new patients
Geps Physician Group of Pennsylvania, PC CurrentSince Dec 26, 2023 Accepting new patients
Tower Health Medical Group CurrentSince Jan 1, 2023 Accepting new patients
Associates in Anesthesia Past Accepting new patients

Locations

3485 Davisville Rd
Hatboro, PA 19040
Phone (215) 830-0400

100 Abbeyville Rd
Lancaster, PA 17603
Phone (717) 397-4261

1718 Spring Creek Rd
Macungie, PA 18062
Phone (610) 366-0500

1194 Naamans Creek Rd
Marcus Hook, PA 19060
Phone (610) 358-6005

5501 Perkiomen Ave
Reading, PA 19606
Phone (610) 779-0600

800 W Miner St
West Chester, PA 19382
Phone (484) 920-6200

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1689942690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LAWRENCE RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083220",
            "telephone_number": "570-947-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD STE 305",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "19013",
            "telephone_number": "610-874-6448",
            "fax_number": "610-876-7399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "706-766-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

Verify at the official NPI Registry.