Jennifer Roberts Evangelista, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

043037 Issued in GA

Practice address

2416 Capstone CT
Columbus, GA 31909-2795

Phone

(706) 327-1281

Fax

(706) 576-9714

NPI assigned

Aug 24, 2006

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

Other identifiers 1

Other names 1

• Jennifer Roberts Evangelist Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rivertown Pediatrics, P.C.

  • Pediatrics Physician
  • Columbus, GA
  • NPI 1346336203
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780791657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 CAPSTONE CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092795",
            "telephone_number": "706-327-1281",
            "fax_number": "706-576-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 CAPSTONE CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092795",
            "telephone_number": "706-327-1281",
            "fax_number": "706-576-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "JENNIFER",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "043037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "043037",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "EVANGELIST",
            "middle_name": "ROBERTS",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shahin Etebar, MD
• Carly Michelle Ethridge
• Victoria Ethridge
• Dajuandra Yvonne Eugene, MED./CCC-SLP
• Walter Evangelista Abreu, MD
• Chelsey Lynne Evangeliste, BA
• Barbara Evans
• Carolyn Marie Evans, CAC I
• Daghia Evans
• Kerry Bodnar Evans, AUD

• Pediatrics Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.