Individual provider Active NPI

Steven P Eveningred, D.C.

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1184864522
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8435 Issued in GA
Practice address
4343 Shallowford Rd
Suite G3
Marietta, GA 30062-5023
Phone
(770) 998-7588
NPI assigned
Feb 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8435 GA Primary

Addresses

Primary practice location

4343 Shallowford Rd
Suite G3
Marietta, GA 30062-5023

Mailing address

4343 Shallowford Rd
Suite G3
Marietta, GA 30062-5023
Phone (770) 998-7588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8435GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Core Neuropathy & Spine Group PastSince Feb 14, 2013 Accepting new patients
Eveningred Chiropractic and Wellness Center, LLC Chiropractor PastSince Sep 13, 2010 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1184864522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD",
            "address_2": "SUITE G3",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625023",
            "telephone_number": "770-998-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD",
            "address_2": "SUITE G3",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625023",
            "telephone_number": "770-998-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVENINGRED",
        "first_name": "STEVEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "8435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.