Individual provider Active NPI

David H Evans, MD

  • Interventional Pain Medicine Physician
  • Dothan, AL
National Provider Identifier
1871572750
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
00016525 Issued in AL
Practice address
1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone
(334) 793-5105
Fax
(334) 671-5073
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 00016525 AL
Pain Medicine (Anesthesiology) Physician 207LP2900X 00016525 AL
Interventional Pain Medicine Physician 208VP0014X 00016525 AL Primary

Addresses

Primary practice location

1108 Ross Clark Cir
Dothan, AL 36301-3022

Mailing address

1118 Ross Clark Circle
Ste 700
Dothan, AL 36301
Phone (334) 793-5105

Other identifiers 3

IdentifierTypeStateIssuer
00495063AOtherGAMEDICAID
000087535MedicaidAL
51087535OtherBCBS OF ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20081215000214 AL Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Interventional Pain Management 1557423274 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00016525ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority CurrentSince Jul 1, 2011 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Anesthesia Consultants Medical Group PC Anesthesiology PastSince Feb 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Interventional Pain Medicine Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 700
Dothan, AL 36301
Phone (334) 793-5105

1118 Ross Clark Cir
Ste 500
Dothan, AL 36301
Phone (334) 794-4159

Interoperability endpoints

  • Direct secure messaging: devans11908@southeasthealth.direct-ci.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1871572750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIRCLE",
            "address_2": "STE 700",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-793-5105",
            "fax_number": "334-671-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-5105",
            "fax_number": "334-671-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DAVID",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "00016525",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AL",
            "license": "00016525",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AL",
            "license": "00016525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "00495063A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000087535",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51087535",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.