Individual provider Active NPI

John Allan Evans, MD

  • Orthopaedic Surgery Physician
  • San Antonio, TX
National Provider Identifier
1912901729
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
E6774 Issued in TX
Practice address
423 Treeline Park
San Antonio, TX 78209-2060
Phone
(210) 351-6500
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X E6774 TX
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X E6774 TX
Orthopaedic Surgery Physician 207X00000X E6774 TX Primary

Addresses

Primary practice location

423 Treeline Park
San Antonio, TX 78209-2060

Mailing address

PO Box 8797
Belfast, ME 04915-8797
Phone (210) 351-6500

Other practice location 1

414 Navarro St
Ste 1128
San Antonio, TX 78205-2516
Phone (210) 351-6500

Other identifiers 2

IdentifierTypeStateIssuer
P02601727OtherTXMCRR
128027307MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040122000989 TX Practitioner - Orthopedic Surgery 9133021975 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E6774TXMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Orthopaedic Surgery CurrentSince Jan 1, 2021 Accepting new patients
C H Wilkinson Physician Network CurrentSince Oct 24, 2019 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 1, 2021 Accepting new patients
C H Wilkinson Physician Network Orthopaedic Surgery CurrentSince Oct 24, 2019 Accepting new patients

Locations

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1912901729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8797",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158797",
            "telephone_number": "210-351-6500",
            "fax_number": "210-351-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 TREELINE PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092060",
            "telephone_number": "210-351-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Navarro St",
            "address_2": "Ste 1128",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782052516",
            "country_code": "US",
            "telephone_number": "210-351-6500",
            "fax_number": "210-351-6509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "ALLAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "TX",
            "license": "E6774",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "E6774",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "E6774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02601727",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128027307",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.