Evan Patrick Vickers

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11000865 Issued in FL

Practice address

3625 University Blvd S
Jacksonville, FL 32216-4207

Phone

(904) 702-6111

NPI assigned

Jan 8, 2019

Sex

Male

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 FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Sunshine State Anesthesia Partners LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1437757127
  Medicare reassignment Care Compare group NPD
• Riverside Anesthesia Services, LLC

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
  • NPI 1134478209

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Vision Anesthesia LLC

  • Anesthesiology Physician
  • Jacksonville, FL
  • NPI 1134740319

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Quiescence Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1942671805

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesiology Professional Services, Inc.

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1902856891
  NPD

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

• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1730652108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 5TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505454",
            "telephone_number": "843-425-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-702-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "EVAN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11000865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Vice, PT, DPT
• Shannon Vice, MD
• Clyde Whitley Vick III, MD
• Lesley-Ann Vickerie, LCSW
• Adrienne Lee Vickers
• Ryan Vickers
• Samantha Juanita Vickers, DNP, CRNA
• Victan of North Carolina, LLC
• Victan, LLC
• Crystal Kaye Victor, O.D.

• Certified Registered Nurse Anesthetist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.