Individual provider Active NPI

Jenna Evans, APRN

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1821636606
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009865A Issued in IN
Practice address
301 Gordon Gutmann Blvd Ste 101
Jeffersonville, IN 47130-3765
Phone
(812) 282-4844
Fax
(812) 282-6248
NPI assigned
Dec 12, 2019
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3014096 KY
Family Nurse Practitioner 363LF0000X 71009865A IN Primary
Registered Nurse 163W00000X 1134874 KY
Registered Nurse 163W00000X 28191999A IN

Addresses

Primary practice location

301 Gordon Gutmann Blvd Ste 101
Jeffersonville, IN 47130-3765

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006000052 IN Practitioner - Nurse Practitioner 2365861689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

301 Gordn Gutmann Blvd
Suite 101
Jeffersonville, IN 47130-3765
Phone (812) 282-4844

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1134874KYMDRegistered Nurse
3014096KYMDNurse Practitioner
71009865AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sellersburg Internal Medicine & Pediatrics CurrentSince Jul 4, 2020 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients

Locations

301 Gordon Gutmann Blvd
Ste 101
Jeffersonville, IN 47130
Phone (812) 282-4844

1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181

130 Hunter Station Way
Ste 202
Sellersburg, IN 47172
Phone (812) 248-0800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2852/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jenna.evans.1@2852.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1821636606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GORDON GUTMANN BLVD STE 101",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303765",
            "telephone_number": "812-282-4844",
            "fax_number": "812-282-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014096",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009865A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1134874",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28191999A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.