Individual provider Active NPI

Raechel Denielle Evans, MD

  • Family Medicine Physician
  • Stillwater, OK
National Provider Identifier
1972128635
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36105 Issued in OK
Practice address
1815 W 6TH Ave
Stillwater, OK 74074-4202
Phone
(405) 743-7300
NPI assigned
Jun 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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 36105 OK Primary

Addresses

Primary practice location

1815 W 6TH Ave
Stillwater, OK 74074-4202

Mailing address

1815 W 6TH Ave
Stillwater, OK 74074-4202
Phone (405) 743-7300

Other names 1

  • Raechel Denielle Evans Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20240111001204 OK Practitioner - Family Practice 0547611832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stillwater Medical Center AuthorityGroup PAC ID 2365353794, 155 clinicians

Practice addresses (Care Compare)

1815 W 6TH Ave
Stillwater Med C Clinic W
Stillwater, OK 74074-2402
Phone (405) 743-7300

Hospital & facility affiliations

  • Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36105OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority Family Medicine CurrentSince Oct 31, 2023 Accepting new patients
Stillwater Medical Center Authority Family Medicine CurrentSince Oct 31, 2023 Accepting new patients
Stillwater Medical Center Physicians Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1815 W 6th Ave
Stillwater, OK 74074
Phone (405) 743-7300

Interoperability endpoints

  • Direct secure messaging: raechel.evans.p1@direct.smc.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1972128635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744202",
            "telephone_number": "405-743-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744202",
            "telephone_number": "405-743-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "RAECHEL",
        "middle_name": "DENIELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "36105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAECHEL",
            "last_name": "EVANS",
            "middle_name": "DENIELLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.