Active NPI
Shauna Evanson, FNP
- Family Nurse Practitioner
- Chandler, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP4906
- Practice address
- 655 S. Dobson Rd
Ste 101
Chandler, AZ 85224 - Phone
- (480) 459-2555
- Fax
- (480) 687-1802
- NPI assigned
- Oct 4, 2010
- Last updated
- Feb 25, 2022
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP4906 | AZ | Primary |
Addresses
Primary practice location
655 S. Dobson Rd
Ste 101
Chandler, AZ 85224
Mailing address
655 S. Dobson Rd
Ste 101
Chandler, AZ 85224
Phone (480) 459-2555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
655 S Dobson Rd
Suite A101
Chandler, AZ 85224-5667
Phone (480) 459-2555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP4906 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lilac Healthcare LLC | Current | Accepting new patients |
Locations
655 S Dobson Rd
Ste 101
Chandler, AZ 85224
Phone (480) 459-2555
655 S Dobson Rd
Ste A101
Chandler, AZ 85224
Phone (480) 855-5900
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1881903102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 S. DOBSON RD",
"address_2": "STE 101",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "85224",
"telephone_number": "480-459-2555",
"fax_number": "480-687-1802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 S. DOBSON RD",
"address_2": "STE 101",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "85224",
"telephone_number": "480-459-2555",
"fax_number": "480-687-1802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANSON",
"first_name": "SHAUNA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-04",
"last_updated": "2022-02-25",
"certification_date": "2022-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP4906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.