JACK L EVANS (NPI# 1033175781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033175781 |
| Entity Type | Individual |
| Full Name | JACK L EVANS |
| Credential | MD |
| Practice Address |
629 N Sandusky Ave Bucyrus OH 44820-1821 |
| Mailing Address |
32 Walker St Tiffin OH 44883-3030 |
| Practice Telephone | 4195624677 |
| Practice Fax Number | 4195620987 |
| Mailing Telephone | 4198424336 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-12-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 35044381 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | BCBS # FOR BUCYRUS | 000000316691 | 01 |
| OH | BCBS | 000000382640 | 01 |
| OH | 0464180 | 05 | |
| RAILROAD MEDICARE | POO328458 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013035401 | Jack Parmer Evans | Internal Medicine | 1301 E South Blvd, Montgomery, AL 36116-2317 | 2007-03-26 |
| 1396784187 | Jack C Evans | Family Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-06 |
| Street Address |
629 N SANDUSKY AVE |
| City | BUCYRUS |
| State | OH |
| Zip Code | 44820-1821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073513164 | Bucyrus Emergency Physicians Inc | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2005-07-29 |
| 1104353648 | Jessica M Hannan | Nurse Practitioner | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2017-05-15 |
| 1689056327 | Kelly Anschutz | Nurse Anesthetist, Certified Registered | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2015-06-18 |
| 1053678201 | Galion Community Hospital | Clinic/Center | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2012-04-12 |
| 1831462779 | Kyle Ann Feasel | Dietitian, Registered | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2012-02-22 |
| 1033499876 | Lisa K Sgambellone | Nurse Practitioner | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2011-08-25 |
| 1629372461 | Bucyrus Community Hospital LLC | General Acute Care Hospital | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2011-01-10 |
| 1629211610 | Ryan Hohman | Pediatrics | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2009-04-07 |
| 1336391051 | Heather Camille Auck | Nurse Practitioner | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2008-10-13 |
| 1275715039 | Bucyrus Community Hospital LLC | Medicare Defined Swing Bed Unit | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2007-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942744974 | Danielle Nichole Adkins | Counselor | 137 Stetzer Road South, Bucyrus, OH 44820 | 2016-12-09 |
| 1720466576 | Mia Knapp | Licensed Practical Nurse | 3792 Ridgeton-annapolis Rd., Bucyrus, OH 44820 | 2015-05-13 |
| 1275963092 | Teena Lohr | Licensed Practical Nurse | 1493 Rosedale Ave, Bucyrus, OH 44820 | 2013-11-14 |
| 1043646276 | Malinda Elizabeth Wells | Licensed Practical Nurse | 359 Arch Dr, Bucyrus, OH 44820 | 2013-09-19 |
| 1811321409 | Lindsey A Powers | Licensed Practical Nurse | 1387 Rosedale Ave., Bucyrus, OH 44820 | 2013-08-30 |
| 1841539475 | Stephen P Mclaughlin | Counselor | 2458 Stetzer Road, Bucyrus, OH 44820 | 2013-02-01 |
| 1780928788 | Georgette Lynn Ball | Registered Nurse | 1355 Lakewood Drive, Bucyrus, OH 44820 | 2012-11-15 |
| 1114106929 | Glen Arthur Mcmurray | Dentist | 126 Hill Street, Bucyrus, OH 44820 | 2007-10-29 |
| 1427245737 | Assisted Living Concepts Inc | Assisted Living Facility | 1721 Whetstone Street, Bucyrus, OH 44820 | 2007-10-01 |
| 1437364874 | Jason D Mease | Home Health Aide | 718 S Spring, Bucyrus, OH 44820 | 2007-05-11 |
| Find all providers in zip 44820 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720045636 | Larry M Tincher | Emergency Medicine | 629 Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-04-26 |
| 1073513164 | Bucyrus Emergency Physicians Inc | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2005-07-29 |
| 1982662706 | Nathaniel Sherman IIi | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-05-02 |
| 1174581904 | John Andrew Stein | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-05-02 |
| 1013973395 | Maura M Manning | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-04-25 |
| 1346206604 | Lawrence A Lewis | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-04-25 |
| 1134185051 | Andrew S Gerken | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-04-21 |
| 1710943568 | David Paul Androw | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-04-21 |
| 1902862683 | David D Jung | Emergency Medicine | 629 N Sandusky Ave, Bucyrus, OH 44820-1821 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023624251 | Chadwick Gordon Rogers | Emergency Medicine | 6605 Rollymeade Ave, Cincinnati, OH 45243-3019 | 2020-09-22 |
| 1003433384 | Emergency Medicine Specialists, Inc. | Emergency Medicine | 1 Kettering Way, Piqua, OH 45356-4109 | 2020-07-02 |
| 1982233953 | Zacharia A Grami | Emergency Medicine | 774 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210 | 2020-04-02 |
| 1528695384 | Chizite Iheonunekwu | Emergency Medicine | 1 Akron General Ave # Aae, Akron, OH 44307-2432 | 2020-03-23 |
| 1790336741 | Ashley Brooke Tincher | Emergency Medicine | 8356 Horseshoe Rd, Ashley, OH 43003-8723 | 2019-09-21 |
| 1871090316 | Integrated Health Medical Consultants LLC | Emergency Medicine | 4487 Village Club Drive, Powell, OH 43065-7156 | 2018-04-11 |
| 1548765126 | Alex Lu | Emergency Medicine | 3000 Arlington Ave., Mailstop 1088, 2456 Dowling Hall, Toledo, OH 43614 | 2018-03-27 |
| 1871097253 | Scotty Fulton | Emergency Medicine | 2213 Cherry Street, Acc, 1st Floor, Toledo, OH 43608 | 2018-03-21 |
| 1821514761 | Roger Hart L'hommedieu Jr. | Emergency Medicine | 7341 Lacosta Dr, Hudson, OH 44236-1804 | 2017-08-22 |
| 1285150599 | Emergency Medicine Care Specialists, Inc | Emergency Medicine | 1620 Royal Oak Dr, Mansfield, OH 44906-3635 | 2017-08-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.