Evan James Michelson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-010285 Issued in AZ

Practice address

2403 N Stockton Hill Rd Ste 4And5
Kingman, AZ 86401-4188

Phone

(928) 529-5311

Fax

(928) 529-5313

NPI assigned

Oct 10, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, 450 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Buckeye, AZ
  • NPI 1467129684
  Medicare reassignment Care Compare group
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Peoria, AZ
  • NPI 1285271684
  NPD (past)

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1245050798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 ARROYO VISTA LN",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864018770",
            "telephone_number": "928-530-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 N STOCKTON HILL RD STE 4AND5",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014188",
            "telephone_number": "928-529-5311",
            "fax_number": "928-529-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSON",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-010285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xochitl A. Mendez, D.O.
• Mentally Ill Kids in Distress
• Conchita O Mercado, DDS
• Michael G Valpiani MD Az LTD
• Michael Stagner,M.D. P.C
• Jack Glenn Miller, CTN
• Marc L Miller, MD
• Mindful Solutions Behavioral Health Services
• Mobility Prosthetic and Orthotic Services LLC
• Mohave Dental Associates PC

• Physical Therapist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.