Active NPI
John Allan Evans, MD
- Orthopaedic Surgery Physician
- San Antonio, TX
National Provider Identifier
1912901729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- E6774
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P02601727 | Other | TX | MCRR |
| 128027307 | Medicaid | TX |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E6774 | TX | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Orthopaedic Surgery | Current | Accepting new patients |
| C H Wilkinson Physician Network | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| C H Wilkinson Physician Network | Orthopaedic Surgery | Current | 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
- 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.
-
- Family Medicine Physician
- Irving, TX
- NPI 1457382947
-
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
Orthopaedic Surgery
-
- Orthopaedic Surgery Physician
- Corpus Christi, TX
- NPI 1750826095
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.