Active NPI
Scott A Evans, D.O.M., L.AC.
- Acupuncturist
- Lodi, CA
National Provider Identifier
1275775363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 529
- Practice address
- 755 S Fairmont Ave
Suite B
Lodi, CA 95240-4643 - Phone
- (209) 339-9888
- Fax
- (209) 339-9888
- NPI assigned
- Apr 3, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC7365 | CA | |
| Acupuncturist | 171100000X | 529 | NM | Primary |
Addresses
Primary practice location
755 S Fairmont Ave
Suite B
Lodi, CA 95240-4643
Mailing address
755 S Fairmont Ave
Suite B
Lodi, CA 95240-4643
Phone (209) 339-9888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC7365 | CA | MD | Acupuncturist |
| 529 | NM | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238716800000",
"number": "1275775363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 S FAIRMONT AVE",
"address_2": "SUITE B",
"city": "LODI",
"state": "CA",
"postal_code": "952404643",
"telephone_number": "209-339-9888",
"fax_number": "209-339-9888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 S FAIRMONT AVE",
"address_2": "SUITE B",
"city": "LODI",
"state": "CA",
"postal_code": "952404643",
"telephone_number": "209-339-9888",
"fax_number": "209-339-9888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SCOTT",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.O.M., L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-03",
"last_updated": "2009-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC7365",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NM",
"license": "529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.