John Edward Evans, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

38545 Issued in KY

Practice address

901 Wallace Ave
Leitchfield, KY 42754-1417

Phone

(270) 259-5641

Fax

(270) 259-5309

NPI assigned

May 27, 2006

Last updated

Jan 30, 2019By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61385
• Direct secure messaging: john.evans@pediatricclinic.directbygreenway.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Leitchfield Pediatric Clinic P.S.C.

  • Rural Health Clinic/Center
  • Leitchfield, KY
  • NPI 1558318543

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

  CMS ownership

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.

• Leitchfield Pediatric Clinic P.S.C.

  • Rural Health Clinic/Center
  • Leitchfield, KY
  • NPI 1558318543

  Pediatrics

  Medicare reassignment NPD
• Owensboro Health Twin Lakes Regional Medical Center, Inc

  dba Owensboro Health Twin Lakes Medical Center

  • General Acute Care Hospital
  • Leitchfield, KY
  • NPI 1285221416
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1952358889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541417",
            "telephone_number": "270-259-5641",
            "fax_number": "270-259-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541417",
            "telephone_number": "270-259-5641",
            "fax_number": "270-259-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "38545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64082829",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendee Marie Embry, MS, PA-C
• Eriksen Chiropractic of Leitchfield PLLC
• Ivan Alexander Escudero, MD
• Tara Lynn Eubank
• Amie Joe Evans, APRN
• Jennifer Lyne Fadel, LCSW
• Fast Pace Kentucky, PLLC
• Anthony Francis Filippone, D.O.
• Ashley Nicole Flener, APRN
• Jane Jones Fletcher, R. PH.

• Pediatrics Physician in Leitchfield, KY
• Providers in Leitchfield, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.