NPIMap

Organization Active NPI

Evolution Chiropractic

  • Chiropractor
  • Idaho Falls, ID
National Provider Identifier
1285006403
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1393 Issued in ID
Legal business name
EVOLUTION CHIROPRACTIC
Practice address
1410 E 17TH St
Idaho Falls, ID 83404-6269
Phone
(208) 552-9600
NPI assigned
Oct 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Dr. Thomas R Bench, D.C
Title
Owner
Phone
(208) 552-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CHIA-1393 ID Primary

Addresses

Primary practice location

1410 E 17TH St
Idaho Falls, ID 83404-6269

Mailing address

1410 E 17TH St
Idaho Falls, ID 83404-6269
Phone (208) 552-9600

National Provider Directory

National Provider Directory

Locations

1410 E 17th St
Idaho Falls, ID 83404
Phone (208) 522-9600

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1285006403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046269",
            "telephone_number": "208-552-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046269",
            "telephone_number": "208-552-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-552-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.