NPIMap

Individual provider Active NPI

Thomas O Evans, M.D.

  • Family Medicine Physician
  • Brattleboro, VT
National Provider Identifier
1801893797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
21 Belmont Ave
Suite 2
Brattleboro, VT 05301-7110
Phone
(802) 257-7792
NPI assigned
Jul 7, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Family Medicine Physician 207Q00000X VT Primary

Addresses

Primary practice location

21 Belmont Ave
Suite 2
Brattleboro, VT 05301-7110

Mailing address

21 Belmont Ave
Suite 2
Brattleboro, VT 05301-7110
Phone (802) 257-7792

Other identifiers 1

IdentifierTypeStateIssuer
0000405MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080716000526 VT Practitioner - Family Practice 7113090606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brattleboro Memorial HospitalGroup PAC ID 9335112929, 70 clinicians

Practice addresses (Care Compare)

17 Belmont Ave
Brattleboro, VT 05301-3498

17 Belmont Ave
Brattleboro, VT 05301-7601

21 Belmont Ave
Brattleboro, VT 05301-7110
Phone (802) 257-8847

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
420008041VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Memorial Hospital Family Medicine CurrentSince Sep 18, 1989 Accepting new patients
Southern Vermont Health Services Corp Past Accepting new patients

Locations

17 Belmont Ave
Brattleboro, VT 05301
Phone (802) 257-8360

19 Belmont Ave
Ste 1202
Brattleboro, VT 05301
Phone (802) 251-8650

19 Belmont Ave
Ste G105
Brattleboro, VT 05301

21 Belmont Ave
Ste 1
Brattleboro, VT 05301
Phone (802) 251-8455

21 Belmont Ave
Ste 2
Brattleboro, VT 05301
Phone (802) 251-8787

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1183852800000",
    "number": "1801893797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BELMONT AVE",
            "address_2": "SUITE 2",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017110",
            "telephone_number": "802-257-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BELMONT AVE",
            "address_2": "SUITE 2",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017110",
            "telephone_number": "802-257-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "THOMAS",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000405",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.