Mystical Evans, FNP-C - Medicare Nurse Practitioner in Canton, GA

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Mystical Evans, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Canton, Georgia. Her current practice location is 1495 Hickory Flat Hwy Ste 100, Canton, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 341-6360.

Mystical Evans is licensed to practice in Georgia (license number RN241432) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982338737.

Contact Information

Mystical Evans, FNP-C
1495 Hickory Flat Hwy Ste 100,
Canton, GA 30115-4266
(678) 341-6360
(678) 626-7900

Map and Direction




Provider's Profile

Full NameMystical Evans
GenderFemale
SpecialityNurse Practitioner - Family
Location1495 Hickory Flat Hwy Ste 100, Canton, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1982338737
  • Provider Enumeration Date: 07/15/2022
  • Last Update Date: 05/09/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 2062894017
  • Enrollment ID: I20220808001171

Medical Identifiers

Medical identifiers for Mystical Evans such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1982338737NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family RN241432 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mystical Evans allows following entities to bill medicare on her behalf.
Entity NameSoutheast Medical Group, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235296054
PECOS PAC ID: 3577559673
Enrollment ID: O20040423000347
Entity NameOmni Virtual Health Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093381709
PECOS PAC ID: 2769883842
Enrollment ID: O20210628000175

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mystical Evans is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mystical Evans, FNP-C
Po Box 459,
Colbert, GA 30628-0459

Ph: () -		Mystical Evans, FNP-C
1495 Hickory Flat Hwy Ste 100,
Canton, GA 30115-4266

Ph: (678) 341-6360

Reviews and Comments


Nurse Practitioner Nurses in Canton, GA

Mrs. Holly Allen, AGACNP-BC
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Mrs. Amy Marie Wheeler, FNP-C
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Mr. William Cole, MSN, APRN, FNP-BC
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Practice Location: 6120 Hickory Flat Hwy, Canton, GA 30115
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Practice Location: 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115
Phone: 770-224-1400    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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