Evolve Wellness & IV Hydration Center LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EVOLVE WELLNESS & IV HYDRATION CENTER LLC

Doing business as

Evolve Mental Health and Wellness

Practice address

5330 Heatherdowns Blvd Ste 207
Toledo, OH 43614-4644

Phone

(419) 314-9535

Fax

(419) 469-5495

NPI assigned

Nov 28, 2022

Organization subpart

Yes

Parent organization

EVOLVE WELLNESS & IV HYDRATION CENTER LLCAs reported in NPPES

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

Authorized official

Name

Tameshia Wiggins, APRNNPI 1891263463

Title

NP-C

Phone

(419) 314-9535

Specialties & licenses 5

Addresses

Other names 1

• Evolve Mental Health and Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in NC, OH2 enrollments

Enrollment records 2

Part of

Evolve Wellness IV Hydrati

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tameshia Wiggins, PMHNP-BC,AGNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Toledo, OH
  • NPI 1891263463

  Multi-Specialty, NC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1265142780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 HEATHERDOWNS BLVD STE 207",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436144644",
            "telephone_number": "419-314-9535",
            "fax_number": "419-469-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 HEATHERDOWNS BLVD STE 207",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436144644",
            "telephone_number": "419-314-9535",
            "fax_number": "419-469-5495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Government Center Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284031796",
            "country_code": "US",
            "telephone_number": "910-786-5045",
            "fax_number": "910-786-5046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVE WELLNESS & IV HYDRATION CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVOLVE WELLNESS & IV HYDRATION CENTER LLC",
        "enumeration_date": "2022-11-28",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "TAMESHIA",
        "authorized_official_title_or_position": "NP-C",
        "authorized_official_telephone_number": "419-314-9535",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Mental Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rodney Everage II
• Ashley Everett, DDS
• Mark Everett, RPH
• Henry Clinton Everitt, CT
• Austreeia Everson
• Kristina Lynn Ewing, CDCA
• Traci Lynn Ewing
• Christopher Reed Ewry, CNP
• Excel Medical Group,LLC
• Excel Pharmacy Care LLC

• Psychiatric/Mental Health Nurse Practitioner in Toledo, OH
• Providers in Toledo, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.