JACOB EVANSUN (FNP-C) – Family Nurse Practitioner, NPI 1770281784
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for JACOB EVANSUN (FNP-C)
350 WOODGROVE DR
ATHENS, GA 306057509
Phone: (253) 314-2374
Type: Mailing
212 HOSPITAL DR
WASHINGTON, GA 306735619
Phone: (706) 678-6944
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $109.
Total Amount is formed as General ($109) + Research ($0) + Ownership ($0) = $109.
Last reported payment date: 2024-08-06 • Largest payer in this snapshot: Astellas Pharma US Inc ($44).
Total Amount
$109
General + Research + Ownership
Payments
6
Total payment records
General Amount
$109
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $44 |
| Lilly USA, LLC | $31 |
| Takeda Pharmaceuticals U.S.A., Inc. | $18 |
| Corcept Therapeutics | $16 |
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: 2023-12-04
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231204002960 | I | Nurse Practitioner | GA | TBD |
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.
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 30605)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | GA | |
| Physician Assistant | GA | |
| Internal Medicine, Pediatric Medicine | GA | |
| Family Practice | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Clinical Social Worker | GA |
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