JERRY EVANS (NPI# 1194827808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194827808 |
| Entity Type | Individual |
| Full Name | JERRY EVANS |
| Credential | MD |
| Practice Address |
1700 Clinton St Muskegon MI 49443 |
| Mailing Address |
Po Box 1487 Muskegon MI 49443-1487 |
| Practice Telephone | 2317284601 |
| Mailing Telephone | 6169751845 |
| Mailing Fax Number | 6169751870 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2010-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
4301057209 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | 930035897 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114478419 | Jerry Joe Evans | Pediatrics | 610 W Ottawa St, Apt. 906, Lansing, MI 48933-1056 | 2016-10-21 |
| 1659439636 | Jerry Evans | Chiropractor | 190 E 18th Ave, Eugene, OR 97401-4160 | 2006-12-04 |
| 1376534941 | Jerry C Evans | Internal Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-11-02 |
| Street Address |
1700 CLINTON ST |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230671 | Great Lakes Specialty Hosptial - Hackley LLC | Long Term Care Hospital | 1700 Clinton St, 2 South, 2nd and 3rd Floors, Muskegon, MI 49442-5502 | 2005-07-28 |
| 1619594959 | Marstie Sue Bunting | Registered Nurse | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-07-02 |
| 1164044830 | Justin R Staley | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-05-15 |
| 1184253312 | Bernadette Mcdermott Dazzo | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-08 |
| 1205465143 | Eric James Applebach | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-03 |
| 1982233888 | Hannah Grace Keirnan Skok | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-03 |
| 1114556073 | Uzair Mohammad Raja | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-03 |
| 1730718784 | Angelic Shonta Dye | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-02 |
| 1932738960 | Stephanie Elizabeth Song | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-02 |
| 1578199477 | Brigid M Kiley | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235179029 | Emergency Health Partners Muskegon | Emergency Medicine | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-08 |
| 1013957992 | Marc Emmett Whitaker | Emergency Medicine | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-07 |
| 1831139716 | James Gilleland | Emergency Medicine | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-07 |
| 1881632305 | Joel Christoper Visser | Physician Assistant | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-04 |
| 1811935364 | Martin James Ruiter | Nurse Practitioner | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-04 |
| 1497792733 | Thomas J Zyniewicz II | Emergency Medicine | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-02 |
| 1568409043 | David Michael Childress | Emergency Medicine | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-01 |
| 1558308031 | Harold Arthur Rummery | Emergency Medicine | 1500 E Sherman Blvd, Muskegon, MI 49443 | 2006-06-01 |
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199477 | Brigid M Kiley | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-03-23 |
| 1558463521 | Kathryn Kampen | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49443 | 2006-09-01 |
| 1134137136 | Erik Sievertsen | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49443 | 2006-08-04 |
| 1366456865 | Gerald Lee Buchanan | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49442-5502 | 2006-07-28 |
| 1275547770 | Brian Smith | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49443 | 2006-07-28 |
| 1619990819 | Stuart Vanderheide | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49443 | 2006-07-26 |
| 1912928110 | Marc Ydenberg | Emergency Medicine | 1700 Clinton St, Muskegon, MI 49442-5502 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770059529 | Zachary Kenneth Brown | Emergency Medicine | 906 S Crapo St, Mt Pleasant, MI 48858-3662 | 2018-10-19 |
| 1356778286 | Donald Smith Pllc | Emergency Medicine | 1905 N Hammond Lake Dr, Bloomfield Hills, MI 48302-0139 | 2013-10-10 |
| 1346486222 | Flushing Road Urgent Care PC | Emergency Medicine | 1301 Flushing Rd, Flint, MI 48504-4710 | 2008-12-26 |
| 1184897209 | Donnell Stephen Newman Jr. | Emergency Medicine | 1460 Lakepointe St, Grosse Pointe Park, MI 48230-1016 | 2008-04-09 |
| 1205849866 | Daryl D Wisdom | Emergency Medicine | 10015 Cascade Rd Se, Lowell, MI 49331-9529 | 2006-08-14 |
| 1134131683 | Rick L Holland | Emergency Medicine | 8333 Felch Ave, Zeeland, MI 49464 | 2006-08-13 |
| 1760493472 | Katherine J Pitus | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
| 1952319881 | Robert Prodinger | Emergency Medicine | 9825 W Gull Lake Dr, Richland, MI 49083-9543 | 2006-08-04 |
| 1164436671 | James Barry Nolin | Emergency Medicine | 1805 Wild Dr, Richland, MI 49083-9361 | 2006-07-28 |
| 1518987072 | Trace Dotson | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
| Find all providers with the same taxonomy | ||||
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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.