SANDRA RENAE EVANS (FNP-BC, FNP-C) – Primary Care Nurse Practitioner, NPI 1114680097

SANDRA RENAE EVANS (FNP-BC, FNP-C) is a healthcare provider. based in Russellville, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC, FNP-C. They hold a License No. 1-069598 (AL). The NPI Number for SANDRA RENAE EVANS (FNP-BC, FNP-C) is 1114680097

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
SANDRA RENAE EVANS (FNP-BC, FNP-C)
NPI
1114680097
Phone
(256) 668-5216
Address
2228 LAWRENCE ST W
Enumeration Date
18 October 2021
Last Update Date
18 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2563312700
Graduation Year
2021 (5 years ago)
PAC ID
0345631461
Group Practice PAC ID
3476878489
Professional Enrollment ID
I20211229000323
Address ID
AL356531969RU1522543XX304
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for SANDRA RENAE EVANS (FNP-BC, FNP-C)

  • 2228 LAWRENCE ST W

    RUSSELLVILLE, AL 356535116

    Phone: (256) 668-5216

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-12-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211229000323INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35653)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476878489View full group profile
NameSpecialtyState
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
Orthopedic SurgeryAL
Psychiatry, Geriatric PsychiatryAL
Hospice/Palliative Care, Geriatric MedicineTN
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL

Reviews

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Frequently asked questions

What identifier follows SANDRA RENAE EVANS (FNP-BC, FNP-C) across health systems?
The NPI 1114680097 uniquely identifies SANDRA RENAE EVANS (FNP-BC, FNP-C) in U.S. healthcare data.
Does the public listing show SANDRA RENAE EVANS (FNP-BC, FNP-C) as active?
SANDRA RENAE EVANS (FNP-BC, FNP-C)'s NPI record reflects an active status in NPPES.
How should patients interpret SANDRA RENAE EVANS (FNP-BC, FNP-C)'s specialty?
The extract shows Primary Care Nurse Practitioner for SANDRA RENAE EVANS (FNP-BC, FNP-C). Clinical services aligned with this taxonomy classification.
Is SANDRA RENAE EVANS (FNP-BC, FNP-C) tied to Russellville, Alabama?
If you are local to Russellville, Alabama, SANDRA RENAE EVANS (FNP-BC, FNP-C) may be relevant to your search.
Why is information missing for SANDRA RENAE EVANS (FNP-BC, FNP-C)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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