Reco Petriccelli Evans, RN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

752302 Issued in TX

Practice address

6108 Balcony Dr
Apt 911
Fort Worth, TX 76132-4167

Phone

(817) 361-6015

Fax

(817) 361-1904

NPI assigned

Jul 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Registered Nurse

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.

• Mark Malone MD PA

  • Pain Medicine (Anesthesiology) Physician
  • Round Rock, TX
  • NPI 1407057250
  NPD (past)

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

{
    "created_epoch": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1841499308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6108 BALCONY DR",
            "address_2": "APT 911",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324167",
            "telephone_number": "817-361-6015",
            "fax_number": "817-361-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6108 BALCONY DR",
            "address_2": "APT 911",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324167",
            "telephone_number": "817-361-6015",
            "fax_number": "817-361-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "RECO",
        "middle_name": "PETRICCELLI",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-15",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "752302",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "752302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiri Evans, M.D.
• Lauren Deeann Evans, MD
• Neil Anson Evans, MD
• Olivia Evans, PTA
• Rebecca Evans, LPC-S
• Rhonda L Evans, LCSW
• Richard Allen Evans Jr., PT, DPT
• Samantha Rene Evans, PA
• Shavonne Evans
• Oluwademilade O Evbuomwan-Buraimoh, FNP-C

• Certified Registered Nurse Anesthetist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.