Precious Grace Castro Evangelista, MSN, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN166173 Issued in GA

Practice address

428 Savannah PL
McDonough, GA 30253-7374

Phone

(140) 443-2838

NPI assigned

Sep 1, 2022

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 GA

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McIntosh Trail Community Service BoardGroup PAC ID 6204818669, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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.

• McIntosh Trail Community Service Board

  • Community/Behavioral Health Agency
  • Griffin, GA
  • NPI 1336317270
  Medicare reassignment Care Compare group NPD
• McIntosh Trail Community Service Board

  • Community/Behavioral Health Agency
  • Griffin, GA
  • NPI 1386708212
  NPD

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1760102487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 SAVANNAH PL",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537374",
            "telephone_number": "404-432-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 SAVANNAH PL",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537374",
            "telephone_number": "140-443-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "PRECIOUS GRACE",
        "middle_name": "CASTRO",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN166173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Euphoria Health and Wellness LLC.
• Eurcocare Medical Center Inc
• Ebony Evans
• Gretchen Evans
• Exceptional Ace LLC
• Exceptional Nursing Care LLC
• Exceptional One Transportation

• Psychiatric/Mental Health Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.