Individual provider Active NPI

Lisa Engel Evans, MSW

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1790991271
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801058791 Issued in MI
Practice address
4260 Plymouth Rd
Ann Arbor, MI 48109
Phone
(734) 647-5675
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801058791 MI Primary

Addresses

Primary practice location

4260 Plymouth Rd
Ann Arbor, MI 48109

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090617000092 MI Practitioner - Clinical Social Worker 8123178993 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince May 4, 2009 Accepting new patients
Regents of the University of Michigan Social Worker CurrentSince May 4, 2009 Accepting new patients

Locations

1500 E Medical Center Dr
Fl 1
Ann Arbor, MI 48109
Phone (734) 936-4054

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

3621 S State St
#700
Ann Arbor, MI 48108

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790991271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-647-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LISA",
        "middle_name": "ENGEL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801058791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.