NPIMap

Individual provider Active NPI

Nichole Marie Evans, FNP

  • Family Nurse Practitioner
  • Pawley's Island, SC
National Provider Identifier
1992241145
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20695 Issued in SC
Practice address
10317 Ocean Highway 17 South
Pawleys Island, SC 29585
Phone
(843) 237-4036
NPI assigned
Jan 11, 2017
Last updated
Mar 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20695 SC Primary

Addresses

Primary practice location

10317 Ocean Highway 17 South
Pawleys Island, SC 29585

Mailing address

4830 Innisbrook CT
#1
Myrtle Beach, SC 29579-6609
Phone (843) 246-1326

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
I20170516001583 SC Practitioner - Nurse Practitioner 2466739750 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital Emergency Professional ServicesGroup PAC ID 2163516980, 20 clinicians

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20695SCMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Oct 15, 2020 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Carolina Family Care, Inc CurrentSince Oct 15, 2020 Accepting new patients
Elite Pain Management, LLC CurrentSince Jun 1, 2020 Accepting new patients
App of South Carolina Ed PLLC CurrentSince Mar 1, 2020 Accepting new patients
Conway Hospital Emergency Professional Services CurrentSince Apr 1, 2024 Accepting new patients
Elite Pain Management, LLC CurrentSince Jun 1, 2020 Accepting new patients
Musc Community Physicians Current Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients

Locations

222 E Primrose St
Ste E
Springfield, MO 65807
Phone (417) 553-1080

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1315 Roberts St
Camden, SC 29020
Phone (803) 432-4311

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

1304 W Bobo Newsom Hwy
Hartsville, SC 29550
Phone (469) 340-1366

4237 River Hills Dr
Ste 170
Little River, SC 29566
Phone (843) 273-0376

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

8212 Devon Ct
Myrtle Beach, SC 29572
Phone (843) 273-0379

Organizations & group practices 10

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1992241145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 INNISBROOK CT",
            "address_2": "#1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796609",
            "telephone_number": "843-246-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10317 OCEAN HIGHWAY 17 SOUTH",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "29585",
            "telephone_number": "843-237-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawley's Island, SC

Sources for this page

Verify at the official NPI Registry.