NPIMap

Organization Active NPI

Evans Physical Therapy & Sport Performance, LLC

  • Physical Therapy Clinic/Center
  • Monroe, NC
National Provider Identifier
1144726928
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EVANS PHYSICAL THERAPY & SPORT PERFORMANCE, LLC
Doing business as
Evans Physical Therapy & Sport Performance
Practice address
2585 W Roosevelt Blvd
Monroe, NC 28110-0418
Phone
(704) 993-6941
NPI assigned
Apr 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Authorized official

Name
Dr. Anthony James Evans, DPTNPI 1588143077
Title
Owner
Phone
(704) 975-0222

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
Physical Therapy Clinic/Center 261QP2000X NC Primary

Addresses

Primary practice location

2585 W Roosevelt Blvd
Monroe, NC 28110-0418

Mailing address

PO Box 404
Mineral Springs, NC 28108-0404
Phone (704) 975-0222

Other names 1

  • Evans Physical Therapy & Sport Performance Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210928003257 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9335546647 Receives reassigned benefits from 2 practitioners
Practice locations: Monroe, NC
O20250219002252 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9335546647 Receives reassigned benefits from 2 practitioners
Practice locations: Indian Land, SC

National Provider Directory

National Provider Directory
Tax ID family
Evans Physical Therapy and Sport Perform2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2585 W Roosevelt Blvd
Monroe, NC 28110
Phone (704) 606-6897

9456 Charlotte Hwy
Ste 104
Indian Land, SC 29707
Phone (803) 839-0278

Practitioners & affiliated clinicians

Practitioners 2

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": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1144726928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 404",
            "city": "MINERAL SPRINGS",
            "state": "NC",
            "postal_code": "281080404",
            "telephone_number": "704-975-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 W ROOSEVELT BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281100418",
            "telephone_number": "704-993-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS PHYSICAL THERAPY & SPORT PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-975-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evans Physical Therapy & Sport Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.