NPIMap

Individual provider Active NPI

Wakesha T Evans, PA-C

  • Medical Physician Assistant
  • North Charleston, SC
National Provider Identifier
1952585564
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
5880 Rivers Ave
North Charleston, SC 29406-6053
Phone
(843) 725-4673
Fax
(843) 725-1235
NPI assigned
Dec 19, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

5880 Rivers Ave
North Charleston, SC 29406-6053

Mailing address

5880 Rivers Ave
North Charleston, SC 29406-6053
Phone (843) 725-4673

Other names 1

  • Mrs. Wakesha T Evans Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20080811000268 SC Practitioner - Physician Assistant 7911071840 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fetter Health Care Network IncGroup PAC ID 9032215199, shared by 15 NPIs, 26 clinicians

Practice addresses (Care Compare)

106 W Main St
Moncks Corner, SC 29461-2601
Phone (843) 761-1995

51 Nassau St
Charleston, SC 29403-5513
Phone (843) 722-4112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1287SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fetter Health Care Network, Inc CurrentSince Nov 7, 2023 Accepting new patients
Fetter Health Care Network, Inc. CurrentSince Nov 7, 2023 Accepting new patients
Fetter Health Care Network, Inc. CurrentSince Nov 7, 2023 Accepting new patients
Fetter Health Care Network, Inc. CurrentSince Nov 7, 2023 Accepting new patients
Liberty Doctors LLC CurrentSince Jul 1, 2018 Accepting new patients
Fetter Health Care Network, Inc. CurrentSince Nov 7, 2023 Accepting new patients
Hopeclinic Walterboro Past Accepting new patients

Locations

35 Walnut St
Charleston, SC 29403
Phone (843) 723-9477

418 Folly Rd
#A
Charleston, SC 29412
Phone (843) 225-8320

51 Nassau St
Charleston, SC 29403

106 W Main St
Moncks Corner, SC 29461
Phone (843) 761-1995

110 Executive Pkwy
Moncks Corner, SC 29461
Phone (843) 899-9099

130 Varnfield Dr
Ste 100
Summerville, SC 29483
Phone (843) 821-3444

679 Orangeburg Rd
Unit F
Summerville, SC 29483
Phone (843) 261-2600

Organizations & group practices 9

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": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1952585564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066053",
            "telephone_number": "843-725-4673",
            "fax_number": "843-725-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066053",
            "telephone_number": "843-725-4673",
            "fax_number": "843-725-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "WAKESHA",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAKESHA",
            "last_name": "EVANS",
            "middle_name": "T",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.