Individual provider Active NPI

Kevan James Evans, D.C.

  • Acupuncturist
  • Maryville, MO
National Provider Identifier
1194828012
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
006606 Issued in MO
Practice address
206 W 2ND St
Maryville, MO 64468-2229
Phone
(660) 582-8099
NPI assigned
Sep 6, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006606 MO
Acupuncturist 171100000X 006606 MO Primary

Addresses

Primary practice location

206 W 2ND St
Maryville, MO 64468-2229

Mailing address

20293 Hawk Rd
Maryville, MO 64468-8301
Phone (660) 582-8948

Other identifiers 1

IdentifierTypeStateIssuer
1352500OtherMOCOMMUNITY HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000163 MO Practitioner - Chiropractic 2860660289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Northwest Chiropractic ClinicGroup PAC ID 6002084415, 2 clinicians

Practice addresses (Care Compare)

206 W 2ND St
Maryville, MO 64468-2229
Phone (660) 582-8099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006606MOMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Chiropractic Clinic Chiropractor CurrentSince May 15, 2011 Accepting new patients
Northwest Chiropractic Clinic, LLC Chiropractor Past Accepting new patients

Locations

206 W 2nd St
Maryville, MO 64468
Phone (660) 582-8099

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1194828012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20293 HAWK RD",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644688301",
            "telephone_number": "660-582-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W 2ND ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682229",
            "telephone_number": "660-582-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KEVAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006606",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MO",
            "license": "006606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "1352500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.