Evan Gregory Smith

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

2200 Bergquist Dr
Lackland a F B, TX 78236-9907

Phone

(210) 292-1990

NPI assigned

Jan 11, 2011

Last updated

Apr 8, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Age Management of West Michigan PCGroup PAC ID 2466686290, 23 clinicians

West Michigan Pain Center PCGroup PAC ID 1355717331, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Age Management of West Michigan PC

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1558700625
  Medicare reassignment Care Compare group NPD
• West Michigan Pain Center PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Grand Rapids, MI
  • NPI 1447973060
  Medicare reassignment Care Compare group
• Citypulse Urgent Care PLLC

  dba Wellcare Urgent Care

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1770041782
  Medicare reassignment
• Labaza Eyecare, P.C.

  • Optometrist
  • Rochester, MI
  • NPI 1619184850
  NPD (past)
• Lansing Urgent Care, PLC

  • Urgent Care Clinic/Center
  • Lansing, MI
  • NPI 1780987990
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1891090577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 WINDING VW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782607206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EVAN",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-11",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Mathew Sirak, OTR
• Catherine Patricia Skerrett, RN, MSN, FNP
• Karen Melanie Sky, M.D.
• Kimberly A Slawinski, MD
• Daniel James Smith, DMD
• Jeanne Kowal Smith, PT
• Keith R. Smith, PMHNP, BC
• Lisa Smith, MPT
• Marley Cranford Smith, LCSW
• Nicole Alexandra Smith, DMD

• Medical Physician Assistant in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.

Verify at the official NPI Registry.