Keith B Evans, ACNS-BC

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

APRN.CNS.19050 Issued in OH

Practice address

12 Lincoln Dr
Shelby, OH 44875-1482

Phone

(419) 961-2873

NPI assigned

Jan 19, 2017

Sex

Male

Sole proprietor

Yes

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 OH

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 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fisher-Titus Hospital Hospital, Norwalk, OH, CCN 360065

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD

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

• Fisher-Titus Medical Center

  • General Acute Care Hospital
  • Norwalk, OH
  • NPI 1992738959
  Care Compare affiliation

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1750828406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LINCOLN DR",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751482",
            "telephone_number": "419-961-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LINCOLN DR",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751482",
            "telephone_number": "419-961-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KEITH",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "ACNS-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "APRN.CNS.19050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Edith
• Angela Elliott
• Olivia Esparza
• James Espy
• David J Etzel, CNP
• Fackler Family Chiropractic, LLC
• Kelsie M Fannin
• Virginia Fields
• Robert Fighter
• Lillith Fischer, LSW

• Adult Health Clinical Nurse Specialist in Shelby, OH
• Providers in Shelby, OH by specialty
• Adult Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.
• 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.