Individual provider Active NPI

Donna L Evans, MD

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1972530525
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
038227 Issued in GA
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 350-8180
Fax
(912) 350-8427
NPI assigned
Jun 27, 2006
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 038227 GA Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

5002 Waters Ave
Savannah, GA 31404-6226
Phone (912) 350-8180

Other practice location 1

5002 Waters Ave
Savannah, GA 31404-6226
Phone (912) 350-8180

Other identifiers 5

IdentifierTypeStateIssuer
G38227MedicaidSC
349757OtherGAWELLCARE
370017873OtherGARR MEDICARE
000597891BMedicaidGA
10064419OtherGAAMERIGROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address devans49550@epicsav.hcadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100113000256 GA Practitioner - Pediatric Medicine 0143255430 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038227GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MPPG, Inc. Pediatrics CurrentSince Feb 28, 2001 Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

Interoperability endpoints

  • Direct secure messaging: devans49550@epicsav.hcadirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1972530525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046226",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-8427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5002 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046226",
            "country_code": "US",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-5697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DONNA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "038227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G38227",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "349757",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "370017873",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000597891B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10064419",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "devans49550@epicsav.hcadirect.net",
            "affiliation": "N",
            "address_1": "5002 Waters Ave",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314046226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.