Timothy J Evans

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R819687 Issued in MS

Practice address

1301 S Adams St
Fulton, MS 38843

Phone

(662) 862-4422

Fax

(662) 862-4244

NPI assigned

Aug 2, 2006

Last updated

Jun 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Hospitalists of Ms, LLC

  • Hospitalist Physician
  • Amory, MS
  • NPI 1467856385
  Medicare reassignment NPD
• United Emergency Services of Mississippi

  • Emergency Medicine Physician
  • Columbus, MS
  • NPI 1801983309

  Nurse Practitioner

  Medicare reassignment NPD
• Acs Primary Care Physicians Louisiana PC

  • Emergency Medicine Physician
  • Alexandria, LA
  • NPI 1306889092

  Nurse Practitioner

  Medicare reassignment NPD
• Comprehensive Hospitalists of Ms, LLC

  • Hospitalist Physician
  • Clarksdale, MS
  • NPI 1710371679
  NPD
• Amory Hma Physician Management LLC

  • Family Medicine Physician
  • Amory, MS
  • NPI 1255361978

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1720095896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3377 JOE WHEELER BROWN RD",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "388437245",
            "telephone_number": "662-790-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S ADAMS ST",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "38843",
            "telephone_number": "662-862-4422",
            "fax_number": "662-862-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R819687",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09666",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R819687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "AP09666",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dogwood Plantation of Fulton
• Dr. Jerry McBride LLC
• Dutch Pharmacies Inc (Family Pharmacy of Fulton)
• James W. Elliott, RRT
• Tara B Enlow, CFNP
• Express Care of Fulton
• Christy L Flynn, PT
• Brenteney Fortune, FNP-C, CRNP
• Kristy S. Franks, FNP
• Sheila Ann Frederick, AGNP-C

• Family Nurse Practitioner in Fulton, MS
• Providers in Fulton, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.