Individual provider Active NPI

Barbara W Evanko, MS, PT

  • Physical Therapist
  • Kennett Square, PA
National Provider Identifier
1780845628
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015539 Issued in PA
Practice address
674 Unionville Rd Ste 101
Kennett Square, PA 19348-4712
Phone
(610) 925-4856
Fax
(610) 925-4859
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015539 PA Primary

Addresses

Primary practice location

674 Unionville Rd Ste 101
Kennett Square, PA 19348-4712

Mailing address

2 W 10TH St
Marcus Hook, PA 19061-4513
Phone (610) 859-8850

Other identifiers 5

IdentifierTypeStateIssuer
102379116-0001MedicaidPA
30070460OtherPAKEYSTONE MERCY
002123074OtherPAHIGHMARK PABS
306143OtherUNISON
3740718000OtherPAIBC

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT015539PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Therapy Services of Pennsylvania LLC Physical Therapist Past Accepting new patients
Bayada Home Health Care, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1780845628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 10TH ST",
            "city": "MARCUS HOOK",
            "state": "PA",
            "postal_code": "190614513",
            "telephone_number": "610-859-8850",
            "fax_number": "610-859-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 UNIONVILLE RD STE 101",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193484712",
            "telephone_number": "610-925-4856",
            "fax_number": "610-925-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANKO",
        "first_name": "BARBARA",
        "middle_name": "W",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102379116-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30070460",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PABS",
            "identifier": "002123074",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "306143",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "3740718000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.