Evans Chiropractic LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

CH6210 Issued in FL

Legal business name

EVANS CHIROPRACTIC LLC

Practice address

3632 Evans Ave
Fort Myers, FL 33901-8314

Phone

(239) 275-7246

NPI assigned

Jul 13, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Richard Blum, D.C.

Title

Owner

Phone

(954) 441-7100

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1093944985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 NW 120TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261944",
            "telephone_number": "954-441-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018314",
            "telephone_number": "239-275-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-441-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "CH6210",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "CH6210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380104700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Usberghi, Jr., D.O.
• Ev Rider, LLC
• Eliza Lynn Evangelista
• Evans Avenue Health Care Clinic, Inc
• Evans Avenue Opco LLC
• Evans Health Care Associates LLC
• D Amanda Evans, LCSW
• Tinikki Shunta Evans
• Sandra Lee Eveleth, O.D.
• Eventus Infusion LLC

• Health Service Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.