KELLY L EVANS M.D. NPI 1700887338

NPI Information

NPI: 1700887338
Provider Name: KELLY L EVANS, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
4545 CORDATA PKWY
BELLINGHAM, WA
ZIP 98226
Phone: (360) 738-2200
Get Directions

Kelly L Evans, M.D. is a family medicine in Bellingham, WA with 29 years of experience. The provider is 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. Kelly L Evans, M.D. NPI is 1700887338. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4545 CORDATA PKWY
BELLINGHAM, WA
ZIP 98226-123
Phone: (360) 738-2200
Fax: (360) 752-5686

The NPI 1700887338 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/4/2005 and was last updated on 9/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		36096988	ILLINOIS	No
2	207Q00000X	Family Medicine		MD60114770	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	L71482	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
2	0031EV	OTHER	WASHINGTON	REGENCE
3	0261814	OTHER	WASHINGTON	L&I AND CRIME VICTIMS
4	5827708	OTHER	WASHINGTON	AETNA
5	G64441	MEDICARE UPIN	ILLINOIS
6	1700887338	MEDICAID	WASHINGTON
7	036096988	MEDICAID	ILLINOIS
8	G8891584	MEDICARE PIN	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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