Individual provider Active NPI

Diane L Evans, CRNP

  • Pediatric Nurse Practitioner
  • Great Falls, MT
National Provider Identifier
1992706873
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN019691 Issued in MT
Practice address
1300 28TH St S
Suite 6
Great Falls, MT 59405-5296
Phone
(406) 731-8888
Fax
(406) 731-8876
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN019691 MT Primary

Addresses

Primary practice location

1300 28TH St S
Suite 6
Great Falls, MT 59405-5296

Mailing address

1300 28TH St S Ste 6
Great Falls, MT 59405-5296
Phone (406) 731-8888

Other identifiers 1

IdentifierTypeStateIssuer
0434070MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diane.evans.p1@direct.benefisbmg.nextgenshare.com Benefis Hospitals Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN019691MTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals Inc Past Accepting new patients
Benefis Hospitals, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: devans18975@benefishs.direct-ci.com

Organizations & group practices 2

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1992706873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 28TH ST S STE 6",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055296",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 28TH ST S",
            "address_2": "SUITE 6",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055296",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MT",
            "license": "RN019691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0434070",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane.evans.p1@direct.benefisbmg.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "1300 28th St S",
            "address_2": "Suite 6",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.