Jeremy Evans

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P16570 Issued in NC

Practice address

740 W Fire Tower Rd Ste 113
Winterville, NC 28590-8411

Phone

(252) 329-8800

NPI assigned

Dec 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peak Performance Sports and Physical Therapy, LLC

  • Physical Therapist
  • New Bern, NC
  • NPI 1194714063
  Medicare reassignment Care Compare group NPD
• Greenville Peak Performance Sports & Physical Therapy, LLC

  • Physical Therapist
  • Winterville, NC
  • NPI 1962603266
  NPD

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1134766710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "616-356-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W FIRE TOWER RD STE 113",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285908411",
            "telephone_number": "252-329-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P16570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Winterville, NC
• Providers in Winterville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.