DR. JACOB EVANS (NPI# 1679772693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679772693 |
| Entity Type | Individual |
| Full Name | DR. JACOB EVANS |
| Credential | DO |
| Practice Address |
16-192 Pili Mua St Keaau HI 96749-8134 |
| Mailing Address |
224 Haili St Suite B Hilo HI 96720-2975 |
| Practice Telephone | 8089300400 |
| Mailing Telephone | 4152152970 |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2011-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DOS-1229 | HI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 20A9697 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104430099 | Jacob C Evans | Behavior Technician | 8200 Gerogia St., Merrillville, IN 46410-6227 | 2020-09-08 |
| 1447784384 | Jacob Evans | Ophthalmology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792 | 2017-04-18 |
| Street Address |
16-192 PILI MUA ST |
| City | KEAAU |
| State | HI |
| Zip Code | 96749-8134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184606899 | Amy J Duerler | Nurse Practitioner | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2005-11-17 |
| 1871113084 | Timothy Jonathan Chuang | Student in an Organized Health Care Education/Training Program | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2020-04-17 |
| 1215556741 | Joshua Bussard | Student in an Organized Health Care Education/Training Program | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2020-04-14 |
| 1932734118 | Chloey Lynsie Jones | Student in an Organized Health Care Education/Training Program | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2020-03-07 |
| 1932766987 | Lauren Yap | Student in an Organized Health Care Education/Training Program | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2019-05-24 |
| 1255812137 | Bay Clinic Inc | Pharmacist | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2018-08-28 |
| 1750635157 | Naomi Summer Whitaker | Nurse Practitioner | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2012-11-07 |
| 1386903631 | Heather Lenore Cantori | Dentist | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2012-05-07 |
| 1033419742 | Kenneth Ooka | Pharmacist | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2010-10-27 |
| 1780833566 | Claudia Marie Roman | Registered Nurse | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2008-09-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326959 | Presence of Mind Inc | Counselor | 15-1942 7th Ave., Keaau, HI 96749 | 2020-11-06 |
| 1700498102 | Thomas Gerard Camenzind | Massage Therapist | 16-426 Brookover Street, Keaau, HI 96749 | 2020-08-18 |
| 1225674542 | Jennifer Archer | Behavior Technician | 16-556 Kea'au Pahoa Rd, 188-111, Kea'au, HI 96749 | 2019-11-21 |
| 1124672712 | Jill Jenkins | Registered Nurse | 15-1680 9th Ave, Keaau, HI 96749 | 2019-07-31 |
| 1467004135 | Evelyn Ramelb | Nursing Home Administrator | 16-1508 35th Ave, Keaau, HI 96749 | 2019-07-12 |
| 1326690157 | Samuel Robert Teare IIi | Behavior Technician | 16-359 Kehaulani St, Keaau, HI 96749 | 2019-07-11 |
| 1942869599 | Tisha Takazawa | Community Health Worker | 16-204 Melekahiwa Place, Suite 3, Keaau, HI 96749 | 2019-06-07 |
| 1154824407 | Kipuka Counseling and Consulting, LLC | Community/Behavioral Health | 15-1463 Awa Ave, Keaau, HI 96749 | 2018-03-13 |
| 1598272536 | Alexander Stitt | Counselor | 15-1963 4th Ave., Keaau, HI 96749 | 2017-12-29 |
| 1164937223 | Rachael Lorraine Hasner | Registered Nurse | 15-1488 Lokelani Ave, Keaau, HI 96749 | 2017-12-11 |
| Find all providers in zip 96749 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568694180 | Bay Care Med Corp | Family Medicine | 16-540 Keaau Pahoa Rd, Ste 2-177, Keaau, HI 96749-8155 | 2009-08-14 |
| 1215195680 | Chrissy Allyn Capati | Family Medicine | 16-192 Pilimua St., Keaau, HI 96749 | 2008-06-01 |
| 1972716348 | Alin Vaunpono Ledford | Family Medicine | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2007-05-08 |
| 1104874619 | Bay Clinic Inc | Family Medicine | 16-192 Pili Mua St, Keaau, HI 96749-8134 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225657307 | Healing Tides Primary Care LLC | Family Medicine | 1110 Nuuanu Ave # A1-182, Honolulu, HI 96817-5119 | 2020-04-09 |
| 1417597063 | Krissy Nichole English | Family Medicine | 65-1116 Hokuula Rd, Kamuela, HI 96743-8355 | 2020-01-12 |
| 1184288102 | Yoonhwan Roh | Family Medicine | 95-390 Kuahelani Ave # J1, Mililani, HI 96789-1192 | 2019-04-24 |
| 1427514645 | Ohana Pacific Medical LLC | Family Medicine | 94-1221 Ka Uka Blvd Unit 108-166, Waipahu, HI 96797-6202 | 2019-02-12 |
| 1265902555 | Liana Tsuruko Kobayashi | Family Medicine | 98-1005 Moanalua Rd Spc 3030, Aiea, HI 96701-4735 | 2018-11-28 |
| 1508332610 | Jasdo, Inc. | Family Medicine | 73-4330 Keo Keo Street, Kailua-kona, HI 96745 | 2018-10-16 |
| 1124506845 | Big Island Family Medicine Inc | Family Medicine | 670 Ponahawai St Ste 207, Hilo, HI 96720-7830 | 2018-08-03 |
| 1669961322 | Micah David | Family Medicine | 1188 Bishop St Ste 802a, Honolulu, HI 96813-3303 | 2018-05-08 |
| 1639666233 | Kahuku Medical Center | Family Medicine | 66-214 Haleiwa Rd, Haleiwa, HI 96712-1510 | 2018-04-18 |
| 1033627930 | Bridget Collins, Md, LLC | Family Medicine | 3175 Elua St Ste C, Lihue, HI 96766-1203 | 2018-01-14 |
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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.