Active NPI
Elena Maryann Evan
- Community Health Worker
- Goodnews Bay, AK
National Provider Identifier
1861020802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 20-10609-I
- Practice address
- Bay Side View 146
Goodnews Bay, AK 99589-0146 - Phone
- (907) 967-2100
- NPI assigned
- Mar 27, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 20-10609-I | AK | Primary |
Addresses
Primary practice location
Bay Side View 146
Goodnews Bay, AK 99589-0146
Mailing address
PO Box 146
Goodnews Bay, AK 99589-0146
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-10609-I | AK | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585267200000",
"number": "1861020802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 146",
"city": "GOODNEWS BAY",
"state": "AK",
"postal_code": "995890146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BAY SIDE VIEW 146",
"city": "GOODNEWS BAY",
"state": "AK",
"postal_code": "995890146",
"telephone_number": "907-967-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVAN",
"first_name": "ELENA",
"middle_name": "MARYANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-27",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "AK",
"license": "20-10609-I",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodnews Bay, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.