Anthony Lee Evans

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

509 S Main St Ste 20
Petal, MS 39465-2203

Phone

(601) 336-4144

Fax

(601) 582-7697

NPI assigned

Feb 21, 2022

Last updated

Feb 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Fit Jam LLC

  dba Visiting Angels

  • In Home Supportive Care Agency
  • Petal, MS
  • NPI 1629704861
  NPD Authorized official

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1922753755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S MAIN ST STE 20",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652203",
            "telephone_number": "601-336-4144",
            "fax_number": "601-582-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 S MAIN ST STE 20",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652203",
            "telephone_number": "601-336-4144",
            "fax_number": "601-582-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ANTHONY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06804375",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drayer Physical Therapy Institute LLC
• Taryn Dyess, COTA/L
• Lesley Thomas Ellison
• Encore Rehabilitation Inc (Encore Rehab of Petal)
• April L Estill, LCSW
• Heather Ezell
• Phillip Matthew Ezell, FNP-BC, AGACNP-BC
• Lorelei Lucas Farr, PHARM.D.
• Marcus Donald Finch
• Fit Jam LLC (Visiting Angels)

• In Home Supportive Care Agency in Petal, MS
• Providers in Petal, MS by specialty
• In Home Supportive Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.