Individual provider Active NPI

Elizabeth M Evans, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1750451498
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00046411 Issued in WA
Practice address
4744 41St Ave SW
Suite 101
Seattle, WA 98116-4570
Phone
(206) 320-5780
Fax
(206) 320-5794
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00046411 WA Primary

Addresses

Primary practice location

4744 41St Ave SW
Suite 101
Seattle, WA 98116-4570

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

9675 SE 36th St Ste 100
Mercer Island, WA 98040-3723
Phone (206) 275-2122

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eevans1041581@wm.providencedirect.org Direct

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00046411WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital & Regional Medical Center 2 Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eevans82346@direct.seattlechildrens.org

Organizations & group practices 1

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1750451498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 41ST AVE SW",
            "address_2": "SUITE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164570",
            "telephone_number": "206-320-5780",
            "fax_number": "206-320-5794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9675 SE 36th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mercer Island",
            "state": "WA",
            "postal_code": "980403723",
            "country_code": "US",
            "telephone_number": "206-275-2122",
            "fax_number": "206-275-0860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00046411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eevans1041581@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9675 SE 36th St Ste 100",
            "city": "Mercer Island",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980403723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.