Individual provider Active NPI

Tia Evenson, APRN

  • Family Nurse Practitioner
  • Chesterfield, MO
National Provider Identifier
1972100766
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025039863 Issued in MO
Practice address
15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone
(636) 237-4700
Fax
(314) 364-6350
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95026529 CA
Family Nurse Practitioner 363LF0000X 2025039863 MO Primary

Addresses

Primary practice location

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004

Mailing address

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA, MO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201008000472 FL Practitioner - Nurse Practitioner 6002235280 Reassigns benefits to 1 organization
I20231213003095 CA Practitioner - Nurse Practitioner 6002235280
I20260304001216 MO Practitioner - Nurse Practitioner 6002235280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

PO Box
Chicago, IL 60677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025039863MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. CurrentSince Jul 15, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 26, 2020 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 26, 2020 Accepting new patients
One Medical Group, Inc CurrentSince Jul 15, 2024 Accepting new patients
Mercy Aco Clinical Services Inc CurrentSince Jan 25, 2026 Accepting new patients
Carbon Health Medical Group of California PC PastSince Jan 1, 2024 Accepting new patients

Locations

1801 Shattuck Ave
Ste A
Berkeley, CA 94709
Phone (510) 225-1025

350 Bon Air Ctr
Ste 200
Greenbrae, CA 94904
Phone (415) 578-3095

1955 Broadway
Ste A
Oakland, CA 94612

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

1708 Cape Coral Pkwy W
Ste 2
Cape Coral, FL 33914
Phone (239) 333-3333

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

400 8th St N
Naples, FL 34102
Phone (239) 261-5511

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1972100766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-237-4700",
            "fax_number": "314-364-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-237-4700",
            "fax_number": "314-364-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVENSON",
        "first_name": "TIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95026529",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025039863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.