NPIMap

Organization Active NPI

Northwest Chiropractic Clinic, LLC

  • Chiropractor
  • Maryville, MO
National Provider Identifier
1235319708
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NORTHWEST CHIROPRACTIC CLINIC, LLC
Practice address
206 W 2ND St
Maryville, MO 64468-2229
Phone
(660) 582-8099
Fax
(660) 582-5161
NPI assigned
Nov 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Dr. Kevan J. Evans, DCNPI 1194828012
Title
Doctor of Chiropractic
Phone
(660) 582-8099

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
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X MO Primary

Addresses

Primary practice location

206 W 2ND St
Maryville, MO 64468-2229

Mailing address

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

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1235319708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W 2ND ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682229",
            "telephone_number": "660-582-8099",
            "fax_number": "660-582-5161"
        },
        {
            "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",
            "fax_number": "660-582-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "KEVAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "660-582-8099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 15, 2007; 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.