High Crest Medical, LLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

HIGH CREST MEDICAL, LLC

Doing business as

High Crest Health

Practice address

50 Fairfield Rd
Fairfield, NJ 07004-2414

Phone

(973) 808-5550

Fax

(973) 808-5999

NPI assigned

Oct 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Eugene L Evans II, MD

Title

Physician

Phone

(973) 808-5550

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• High Crest Health Doing business as

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1033444021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 FAIRFIELD RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042414",
            "telephone_number": "973-808-5550",
            "fax_number": "973-808-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FAIRFIELD RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042414",
            "telephone_number": "973-808-5550",
            "fax_number": "973-808-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH CREST MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "973-808-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RENDERING PROVIDER NUMBER",
            "identifier": "044862WGE",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Crest Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction Medicine (Internal Medicine) Physician in Fairfield, NJ
• Providers in Fairfield, NJ by specialty
• Addiction Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.