Active NPI
Shannon Evans, P.A.
- Physician Assistant
- Elizabethtown, NC
National Provider Identifier
1851477574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100592
- Practice address
- 501 S Poplar St
Elizabethtown, NC 28337-9375 - Phone
- (910) 862-5100
- Fax
- (910) 862-1238
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100592 | NC | Primary |
Addresses
Primary practice location
501 S Poplar St
Elizabethtown, NC 28337-9375
Mailing address
PO Box 398
Elizabethtown, NC 28337-0398
Phone (910) 862-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100592 | Other | NC | STATE LICENSE NC |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100592 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lumberton Emergency Physicians | Past | Accepting new patients | |
| Lumberton Emergency Medical Associates PC | 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.
-
- Emergency Medicine Physician
- Lumberton, NC
- NPI 1326337163
-
- Emergency Medicine Physician
- Lumberton, NC
- NPI 1902049232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1851477574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 398",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "283370398",
"telephone_number": "910-862-5100",
"fax_number": "910-862-1238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S POPLAR ST",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "283379375",
"telephone_number": "910-862-5100",
"fax_number": "910-862-1238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SHANNON",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100592",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NC",
"identifier": "100592",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, NC
- Elizabethtown Nursing Center, Inc.
- Elizabethtown Rescue Squad
- Danny L Ellis Jr., D.C.
- Elwell Ferry Inpatient Services
- Julie Taylor Evans, PHARMD
- Family Alternatives, Inc.
- Family Alternatives, Inc.
- Tiffany Fassnacht Robinson, PHARMD/MSCR
- Fayetteville Orthopaedic Clinic, PA
- First Flight Emergency Physicians LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.