Individual provider Active NPI

Angela R Evans, NP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1700935293
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
137531 Issued in GA
Practice address
980 Johnson Fy Rd NE Ste 110
Atlanta, GA 30342-1607
Phone
(404) 303-7004
Fax
(404) 303-7020
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Registered Nurse 163WS0121X 1568 GA
Nurse Practitioner 363L00000X 137531 GA
Family Nurse Practitioner 363LF0000X 137531 GA Primary

Addresses

Primary practice location

980 Johnson Fy Rd NE Ste 110
Atlanta, GA 30342-1607

Mailing address

980 Johnson Fy Rd NE Ste 110
Atlanta, GA 30342-1607
Phone (404) 303-7004

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

State licenses

LicenseStateTypeSpecialty
1568GAMDPlastic Surgery Registered Nurse
137531GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1700935293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE STE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421607",
            "telephone_number": "404-303-7004",
            "fax_number": "404-303-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE STE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421607",
            "telephone_number": "404-303-7004",
            "fax_number": "404-303-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ANGELA",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0121X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Plastic Surgery",
            "state": "GA",
            "license": "1568",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "137531",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "137531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.