Individual provider Active NPI

John Michael Evans, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Shreveport, LA
National Provider Identifier
1851681217
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
312414 Issued in LA
Practice address
1453 E Bert Koun Loop
Shreveport, LA 71105-6800
Phone
(318) 681-1968
Fax
(318) 465-0077
NPI assigned
Apr 19, 2011
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 312414 LA Primary

Addresses

Primary practice location

1453 E Bert Koun Loop
Shreveport, LA 71105-6800

Mailing address

2900 Saint Michael Dr
Ste 401
Texarkana, TX 75503-5211
Phone (903) 614-7693

Other practice location 1

619 19th St S
Birmingham, AL 35249-1900
Phone (205) 934-3065

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190802000192 LA Practitioner - Thoracic SurgeryPractitioner - General Surgery 9234375759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
Louisiana State University School of Medicine in New Orleans, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)27
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jun 27, 2019 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jun 27, 2019 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients

Locations

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1453 E Bert Kouns Industrial Loop
Ste 319
Shreveport, LA 71105
Phone (318) 681-1675

2900 Saint Michael Dr
Ste 401
Texarkana, TX 75503
Phone (903) 614-5353

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: jevans239779@christushealth.direct-ci.net

Organizations & group practices 4

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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1851681217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT MICHAEL DR",
            "address_2": "STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035211",
            "telephone_number": "903-614-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUN LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-681-1968",
            "fax_number": "318-465-0077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352491900",
            "country_code": "US",
            "telephone_number": "205-934-3065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "LA",
            "license": "312414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.