EDWARD THEODORE EVANS (NPI# 1144319039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144319039 |
| Entity Type | Individual |
| Full Name | EDWARD THEODORE EVANS |
| Credential | M.D. |
| Practice Address |
121 Sotoyome St Santa Rosa CA 95405-4823 |
| Practice Telephone | 7075464062 |
| Practice Fax Number | 7075786258 |
| Mailing Telephone | 7075464062 |
| Mailing Fax Number | 7075786258 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2085B0100X |
Radiology Specialization: Body Imaging |
A22103 | CA | Allopathic & Osteopathic Physicians |
| X | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
A22103 | CA | Allopathic & Osteopathic Physicians |
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A22103 | CA | Allopathic & Osteopathic Physicians |
| X | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
A22103 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A221030 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275909863 | Edward E Evans Jr. | Dentist | Landstul Dental Activity, Bldg 3703 Kirchberg Kaserne, Landstuhl, RP 66849 | 2015-08-18 |
| 1164470035 | Edward E Evans | Obstetrics & Gynecology | 15 Madison Professional Park, Rexburg, ID 83440-2057 | 2006-05-04 |
| 1568079275 | Edward J Evans Jr. | Social Worker | 7232 Justin Way, Mentor, OH 44060-4881 | 2020-09-26 |
| 1124458047 | Edward Evans | Social Worker | 1216 Arch St, Philadelphia, PA 19107-2835 | 2013-11-13 |
| 1174968523 | Edward Evans | Physical Therapist | 95 Washington St, Canton, MA 02021-4006 | 2013-04-29 |
| 1578703161 | Edward Harold Evans | Pediatrics | 10833 Le Conte Ave, B2-325, Los Angeles, CA 90095-3075 | 2009-02-23 |
| 1437293446 | Edward Barton Evans | Internal Medicine | 161 Thunder Dr, Suite 104, Vista, CA 92083-6016 | 2007-02-16 |
| 1386708006 | Edward Evans | Internal Medicine | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-20 |
| 1083799985 | Edward M Evans | Internal Medicine | 1331 N 7th St Ste 375, Phoenix, AZ 85006-2707 | 2006-10-26 |
| 1073545687 | Edward Copelan Evans II | Specialist/Technologist | 468 Caspari St, Athletic Fieldhouse, N. S. U., Natchitoches, LA 71497-0003 | 2006-07-06 |
| Street Address |
121 SOTOYOME ST |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023089729 | Marlene Patricia Lennon | Nurse Practitioner | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-01-30 |
| 1821417296 | Nicholas Mcgarvey | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2014-04-14 |
| 1326461708 | Redwood Radiology Group Inc | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2014-01-21 |
| 1225471337 | Alexander Page | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2013-04-09 |
| 1275819641 | Kathleen A Mott | Nurse Practitioner | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-10-28 |
| 1720373376 | Anusuya Mokashi | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-06-12 |
| 1558651091 | Vivek G. Sahani | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-04-18 |
| 1043531643 | Gary Raymond Roper | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2010-06-17 |
| 1316176712 | Lesley M Field | Physician Assistant | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2009-07-07 |
| 1578797601 | Raymond F. Conway IIi | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2009-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467541367 | David Allen Feinberg | Radiology | 990 Sonoma Ave Ste 15, Santa Rosa, CA 95404-4813 | 2006-10-11 |
| 1154401990 | Michael Dixon Shane | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-16 |
| 1609956465 | Michael Joseph Williams | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-16 |
| 1568542306 | Gary Thomas Shaw | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-16 |
| 1851471601 | Roy Kazuo Sumida | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-16 |
| 1174613871 | John Joseph Mcgovern | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-13 |
| 1245320704 | Mark J Popovich | Radiology | 3883 Airway Dr Ste 100, Santa Rosa, CA 95403-1672 | 2006-10-13 |
| 1871683326 | Frank Edward Modic | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-13 |
| 1922198472 | Harold Edward Phillips | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-13 |
| 1467542928 | Craig Allan Polson | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-10-13 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on EDWARD THEODORE EVANS.
| 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.