NPIMap

Organization Active NPI

Evolved Health Chiropractic & Sports Medicine PLLC

Doing business as Evolved Health Chiropractic & Sports Medicine

  • Chiropractor
  • Woburn, MA
National Provider Identifier
1063984045
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EVOLVED HEALTH CHIROPRACTIC & SPORTS MEDICINE PLLC
Doing business as
Evolved Health Chiropractic & Sports Medicine
Practice address
8 Cedar St Ste 61
Woburn, MA 01801-6362
Phone
(781) 460-0939
Fax
(781) 305-3124
NPI assigned
Jan 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Authorized official

Name
James C Ellis, DCNPI 1992128037
Title
Owner/Member
Phone
(781) 460-0939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

8 Cedar St Ste 61
Woburn, MA 01801-6362

Mailing address

8 Cedar St Ste 61
Woburn, MA 01801-6362
Phone (781) 460-0939

Other practice location 1

37 Village Sq
Chelmsford, MA 01824-2712
Phone (978) 505-7813

Other names 1

  • Evolved Health Chiropractic & Sports Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1063984045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CEDAR ST STE 61",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016362",
            "telephone_number": "781-460-0939",
            "fax_number": "781-305-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CEDAR ST STE 61",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016362",
            "telephone_number": "781-460-0939",
            "fax_number": "781-305-3124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Village Sq",
            "address_purpose": "LOCATION",
            "city": "Chelmsford",
            "state": "MA",
            "postal_code": "018242712",
            "country_code": "US",
            "telephone_number": "978-505-7813",
            "fax_number": "978-856-7729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVED HEALTH CHIROPRACTIC & SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-01",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "781-460-0939",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolved Health Chiropractic & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolved Health Chiropractic & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.