Active NPI
Fay C Evans, ARNP
- Women's Health Nurse Practitioner
- Sedalia, MO
National Provider Identifier
1770580656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 135682
- Practice address
- 3700 W 10TH St
Suite 100
Sedalia, MO 65301-2540 - Phone
- (660) 827-0015
- Fax
- (660) 827-7425
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 135682 | MO | Primary |
Addresses
Primary practice location
3700 W 10TH St
Suite 100
Sedalia, MO 65301-2540
Mailing address
601 E 14TH St
P O Box 1706
Sedalia, MO 65301-5972
Phone (866) 678-5627
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 427941232 | Medicaid | MO | |
| 500029741 | Other | MO | PALMETTO GBA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135682 | MO | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1770580656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E 14TH ST",
"address_2": "P O BOX 1706",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653015972",
"telephone_number": "866-678-5627",
"fax_number": "660-827-3742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 W 10TH ST",
"address_2": "SUITE 100",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653012540",
"telephone_number": "660-827-0015",
"fax_number": "660-827-7425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "FAY",
"middle_name": "C",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MO",
"license": "135682",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "427941232",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA",
"identifier": "500029741",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sedalia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.