Evergrowth Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EVERGROWTH CHIROPRACTIC LLC

Practice address

1263 E Silverado Ranch Blvd Ste 105a
Las Vegas, NV 89183-5946

Phone

(702) 389-5009

NPI assigned

Sep 24, 2020

Last updated

Sep 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Willie So, DCNPI 1760940555

Title

Owner

Phone

(702) 389-5009

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Willie So, DC

  • Chiropractor
  • Las Vegas, NV
  • NPI 1760940555
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1235746140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 E SILVERADO RANCH BLVD STE 105A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835946",
            "telephone_number": "702-389-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 E SILVERADO RANCH BLVD STE 105A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835946",
            "telephone_number": "702-389-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGROWTH CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "SO",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-389-5009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Everhart
• Gina Christina Everitt
• Everlast Wellness Group LLC
• Katie Everly, DPT

• Chiropractor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Chiropractor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.