NPIMap

Individual provider Active NPI

Roy D Evans, M.D.

  • Family Medicine Physician
  • Prentiss, MS
National Provider Identifier
1952465619
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13317 Issued in MS
Practice address
1320 Winfield Ave
Prentiss, MS 39474-3219
Phone
(601) 792-1172
Fax
(601) 792-1267
NPI assigned
Dec 20, 2006
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13317 MS Primary

Addresses

Primary practice location

1320 Winfield Ave
Prentiss, MS 39474-3219

Mailing address

1320 Winfield Ave
Prentiss, MS 39474-3219
Phone (601) 792-1172

Other identifiers 2

IdentifierTypeStateIssuer
01456013MedicaidMS
0111136MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412001393 MS Practitioner - Family PracticePractitioner - Emergency Medicine 5698769784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ware Family Practice LLCGroup PAC ID 4486020633, 3 clinicians

Practice addresses (Care Compare)

972 Columbia Ave
Prentiss, MS 39474-5405
Phone (601) 543-5859

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13117MSMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Health Care , LLC CurrentSince Jan 18, 2019 Accepting new patients
Ware Family Practice LLC CurrentSince Aug 1, 2025 Accepting new patients
Prentiss Primary Care, P.a. CurrentSince Aug 1, 2025 Accepting new patients
Exigence, LLC Past Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
McLemore Emergency Physicians PastSince Dec 18, 2007 Accepting new patients
Nes Tennessee, Inc. Past Accepting new patients
Forrest County General Hospital Past Accepting new patients
Conx Care Corporation Family Medicine Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Delta Medical Group Family Medicine Past Accepting new patients
Edward Kofi Lartevi MD PMC Past Accepting new patients

Locations

4297 Hwy 42
Bassfield, MS 39421
Phone (601) 943-5060

4297 Hwy 42
Bassfield, MS 39421
Phone (601) 943-5060

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

15 Keystone Dr
Ste E
Hattiesburg, MS 39402
Phone (601) 606-6326

300 Cahal St
Hattiesburg, MS 39401
Phone (601) 582-9157

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

972 Columbia Ave
Prentiss, MS 39474
Phone (601) 543-5859

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13169/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: roy.evans.1@8276.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Jefferson Davis Extended Care FacilityPrentiss, MS, CCN 255050 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2015
May 7, 2025

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1952465619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WINFIELD AVE",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394743219",
            "telephone_number": "601-792-1172",
            "fax_number": "601-792-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WINFIELD AVE",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394743219",
            "telephone_number": "601-792-1172",
            "fax_number": "601-792-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ROY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "13317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01456013",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111136",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prentiss, MS

Sources for this page

Verify at the official NPI Registry.