LARRY EVANS (NPI# 1710421912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710421912 |
| Entity Type | Individual |
| Full Name | LARRY EVANS |
| Practice Address |
621 W Madrone St 621 W Madrone Street Roseburg OR 97470-3090 |
| Practice Telephone | 5414920241 |
| Mailing Telephone | 5414920241 |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083682439 | Larry A Evans | Dermatology | 79 Turnpike Ave, Portsmouth, RI 02871-1419 | 2006-03-10 |
| 1770557373 | Larry W Evans | Anesthesiology | 6202 Iola Ave Ste 101, Lubbock, TX 79424-2729 | 2006-02-13 |
| 1104815042 | Larry James Evans | Dentist | 2133 Pepperrell St Bldg 3352, Jbsa Lackland, TX 78236 | 2005-10-13 |
| 1730727660 | Larry Brian Evans | Dentist | 55 Towler Rd, Lawrenceville, GA 30046-4717 | 2019-12-10 |
| 1093089492 | Larry Evans Jr. | Counselor | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2012-03-02 |
| 1699959437 | Larry Evans | Counselor | 1654 E Union St, Greenville, MS 38703-3250 | 2007-12-27 |
| 1669540522 | Larry Craig Evans | Internal Medicine | 2770 Cortez Ave, Idaho Falls, ID 83404-7590 | 2006-11-30 |
| 1922198589 | Larry Evans | Psychologist | 800 Marshall St # 653, Little Rock, AR 72202-3510 | 2006-10-13 |
| 1427069020 | Larry Burnett Evans | Dentist | 200 Mlk Jr Blvd, Wichita Falls, TX 76301-1152 | 2006-08-10 |
| 1356316202 | Larry D Evans | Dentist | 3550 S 4th St, Suite 240, Leavenworth, KS 66048-5071 | 2006-02-22 |
| Street Address |
621 W MADRONE ST 621 W MADRONE STREET |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97470-3090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174571244 | Linda Lou Westfall | Nurse Practitioner | 621 W Madrone St, Suite 223, Roseburg, OR 97470-3090 | 2006-05-04 |
| 1093322919 | Natasha Ritson | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-24 |
| 1427664630 | Sara Clark | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-22 |
| 1538775754 | Aurora Petterson | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-22 |
| 1730794884 | Paige Nicole Hosford | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-14 |
| 1922612035 | Fatima Jalloh | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-04 |
| 1013528272 | Mae L Hoopes | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-08-12 |
| 1265040018 | Angelica Laurent | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-07-17 |
| 1417574898 | Bryn Orr | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-07-01 |
| 1508481912 | Jeremy Michael Smith | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
| 1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
| 1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
| 1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
| 1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
| 1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
| Find all providers in zip 97470 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710330386 | Serenity Lane | Counselor | 2575 Nw Kline St, Roseburg, OR 97471-8827 | 2016-07-19 |
| 1306205984 | Susan Anne Dowell | Counselor | 548 Se Jackson Street, Roseburg, OR 97470-0254 | 2016-02-11 |
| 1528426517 | William C. Poulter | Counselor | 548 Sw Jackson St, Roseburg, OR 97470-2709 | 2016-02-04 |
| 1508295668 | Adapt | Counselor | 1215 Se Court Ave, Roseburg, OR 97470-4329 | 2013-11-08 |
| 1174952238 | Adapt | Counselor | 550 Se Jackson St, Roseburg, OR 97470-4923 | 2013-11-08 |
| 1639508708 | Adapt | Counselor | 1036 Se Douglas Ave, Roseburg, OR 97470-3301 | 2013-11-08 |
| 1245597582 | Alison Marie Hinson | Counselor | 850 Se Rose St, Roseburg, OR 97470-3942 | 2012-04-11 |
| 1114112133 | Delila S Donaldson | Counselor | 727 Se Cass Ave Ste 223, Roseburg, OR 97470-4953 | 2007-09-12 |
| 1639256431 | Linda Witbeck | Counselor | 913 Garden Valley Blvd, Bldg 2, Ward 2, Sartp, Roseburg, OR 97470 | 2006-11-01 |
| 1750373346 | Adapt | Counselor | 548 Se Jackson St, Roseburg, OR 97470-4983 | 2005-08-18 |
| Find all providers in ROSEBURG | ||||
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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.