NPIMap

Organization Active NPI

Evolve Care

  • Community/Behavioral Health Agency
  • Winston Salem, NC
National Provider Identifier
1003052119
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EVOLVE CARE
Practice address
897 Peters Creek Pkwy Ste 101
Winston Salem, NC 27103-3858
Phone
(336) 725-9135
Fax
(336) 725-9139
NPI assigned
Dec 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Jannet Tisdale Blue, QMHP
Title
Clinical Director
Phone
(336) 926-6463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

897 Peters Creek Pkwy Ste 101
Winston Salem, NC 27103-3858

Mailing address

897 Peters Creek Pkwy Ste 101
Winston Salem, NC 27103-3858
Phone (336) 725-9135

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1003052119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 PETERS CREEK PKWY STE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033858",
            "telephone_number": "336-725-9135",
            "fax_number": "336-725-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 PETERS CREEK PKWY STE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033858",
            "telephone_number": "336-725-9135",
            "fax_number": "336-725-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "JANNET",
        "authorized_official_middle_name": "TISDALE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "336-926-6463",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "QMHP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.