Kelly Nicole Evans, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ML20008094 Issued in WA

Practice address

1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340

Phone

(206) 543-0065

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kevans9772@direct.seattlechildrens.org

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.

• The Association of Chrmc and University Physicians

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1255449963
  Medicare reassignment
• Children'S Hospital & Regional Medical Center 2

  • Children's Hospital
  • Seattle, WA
  • NPI 1083789630
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1720196264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "M/S W7847, BOX 5371, CRANIOFACIAL CTR.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-854-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "C-212, BOX 356340",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956340",
            "telephone_number": "206-543-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML20008094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Hyde Evans
• Jeffrey Lewis Evans, MD
• John Richard Evans, DDS
• Kathryn Ann Evans
• Kedemah Evans
• Kimberly C Evans, M.A. SPED
• Kristen Evans
• Kyla Marie Evans, LICSW
• L. Victoria Evans, LW
• Laura E. Evans, MD

• Pediatrics Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.