MS. MARY L EVENSON


Address: 752 N High Point Rd, Dean Medical Center, Madison, WI 53717-2236
Phone: 6088244000

MS. MARY L EVENSON (NPI# 1659366565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659366565
Entity Type Individual
Full Name MS. MARY L EVENSON
Credential PA-C
Practice Address 752 N High Point Rd
Dean Medical Center
Madison
WI 53717-2236
Practice Telephone 6088244000
Practice Fax Number 6088244910
Mailing Telephone 6088244000
Mailing Fax Number 6088244910
Enumeration Date 2005-09-16
Last Update Date 2008-12-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
1019-023 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
DEAN HEALTH INSURANCE 60842 01
WI 42990900 05

Office Location

Street Address 752 N HIGH POINT RD
DEAN MEDICAL CENTER
City MADISON
State WI
Zip Code 53717-2236

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538726781 Erin S Voigt Speech-Language Pathologist 752 N High Point Rd, Madison, WI 53717-2236 2019-05-23
1639652019 Katie Schmidt Occupational Therapist 752 N High Point Rd, Madison, WI 53717-2236 2018-09-11
1952896201 Tiffany Marie Bower Speech-Language Pathologist 752 N High Point Rd, Madison, WI 53717-2236 2018-06-28
1942728316 Kaitlyn Israel Physician Assistant 752 N High Point Rd, Madison, WI 53717-2236 2017-09-06
1104376136 Pakou Vang Cook Speech-Language Pathologist 752 N High Point Rd, Madison, WI 53717-2236 2016-10-13
1528513108 David Vogt Nurse Practitioner 752 N High Point Rd, Madison, WI 53717-2236 2016-08-24
1861946303 Brenda S Basile Pharmacist 752 N High Point Rd, Madison, WI 53717-2236 2016-08-13
1750732111 Sheila M. Opelt Physician Assistant 752 N High Point Rd, Madison, WI 53717-2236 2016-06-28
1215308531 Mandy N Honeywell Audiologist 752 N High Point Rd, Madison, WI 53717-2236 2015-10-13
1699145771 Lindsey Crubaugh Pharmacist 752 N High Point Rd, Madison, WI 53717-2236 2015-10-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720540164 Apex Chiropractic Center LLC Chiropractor 562 Junction Road, Madison, WI 53717 2019-04-04
1467943795 Brittany Macrander Speech-Language Pathologist 701 Deming Way, Madison, WI 53717 2018-05-22
1144622614 Christopher Leclair Pharmacist 7942 Tree Ln, Suite 201, Madison, WI 53717 2014-09-16
1740617430 Martha Darlene Kniffin Marriage & Family Therapist 1805 Excelsior Dr, The Family Center, Madison, WI 53717 2013-09-26
1740538305 Amber J Thompson Specialist 8202 Excelisor Dr, Madison, WI 53717 2012-08-29
1457622938 Kimberly F Lauth Physician Assistant 1200 Q Hammons Drive, Suite 400, Madison, WI 53717 2012-01-16
1699042499 Cameron K Birch Pharmacist 9741 Tree Lane, Suite 201, Madison, WI 53717 2011-11-22
1508023102 Katherine Jo Hartkopf Pharmacist 8501 Excelsior Drive, Rm. 337, Madison, WI 53717 2008-05-21
1366614885 Periodontal & Implant Specialists of Madison, LLC Dentist 49 N Walbridge Ave., Madison, WI 53717 2008-03-25
1598961005 John H Greist Psychiatry & Neurology Healthcare Technology Systems, Inc., 7617 Mineral Point Rd., Ste. 300, Madison, WI 53717 2007-06-22
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962804211 Miranda Street Sudduth Physician Assistant 1607 Doctors Drive, Madison, MS 39110 2014-09-18
1184944068 Thomas Harvey Greene IIi Physician Assistant 248 Ne Hancock Ave, Madison, FL 32340-2560 2010-06-02
1699001735 Chad Jamison Gilliam Physician Assistant 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 2009-10-24
1679763700 Tamara A Melone Physician Assistant 2802 International Lane, Madison, WI 53708-0017 2007-07-25
1932237138 Craig Michael Roberts Physician Assistant 2631 Chamberlain Ave, Madison, WI 53705-3717 2007-03-01
1639234610 Sally-ann P Johannsen Physician Assistant 717 Hidden Cave Rd, Madison, WI 53717-2755 2006-12-27
1023105467 Nicole Anna Hanson Physician Assistant 1617 Sherman Avenue, Madison, WI 53708-0017 2006-10-06
1730137548 Renee A Knutson Physician Assistant 38 Hidden Hollow Trl, Madison, WI 53717-2501 2006-05-04
1669439329 Deanna J Nakada Physician Assistant 750 University Row, Madison, WI 53705-1311 2006-04-27
1326002213 Angela K Vitcenda Physician Assistant 701 Dane Street, Madison, WI 53713 2006-04-17
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Competitor

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City MADISON
Zip Code 53717

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Dataset Information

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.

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