Individual provider Active NPI

Kadesha Clark Evans, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Iowa City, IA
National Provider Identifier
1770303547
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G182509 Issued in IA
Practice address
1566 S Gilbert St Unit 1023
Iowa City, IA 52240-4304
Phone
(319) 853-8378
NPI assigned
Oct 15, 2024
Last updated
May 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G182509 IA Primary

Addresses

Primary practice location

1566 S Gilbert St Unit 1023
Iowa City, IA 52240-4304

Mailing address

1566 S Gilbert St Unit 1023
Iowa City, IA 52240-4304
Phone (319) 853-8378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260421000010 FL Practitioner - Nurse Practitioner 5698241230 Reassigns benefits to 1 organization
I20260422000324 OH Practitioner - Nurse Practitioner 5698241230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eleanor Health Professional Oh, LLCGroup PAC ID 7618384447, 6 clinicians

Practice addresses (Care Compare)

789 White Pond Dr
Suite C
Akron, OH 44320-4203
Phone (330) 355-3153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G182509IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moonstone Mental Health Services PLLC Single Specialty CurrentSince Feb 9, 2025 Accepting new patients

Locations

1566 S Gilbert St
Unit 1023
Iowa City, IA 52240
Phone (319) 853-8378

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1770303547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1566 S GILBERT ST UNIT 1023",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522404304",
            "telephone_number": "319-853-8378",
            "fax_number": "319-253-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 S GILBERT ST UNIT 1023",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522404304",
            "telephone_number": "319-853-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KADESHA",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G182509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.