NPIMap

Organization Active NPI

The Evolution Group Inc.

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1285801191
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THE EVOLUTION GROUP INC.
Practice address
218 Broadway Blvd SE
Albuquerque, NM 87102-3425
Phone
(505) 242-6988
Fax
(505) 242-6972
NPI assigned
May 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Authorized official

Name
Mr. Daniel Blackwood, LPCCNPI 1063662302
Title
Director
Phone
(505) 242-6988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

218 Broadway Blvd SE
Albuquerque, NM 87102-3425

Mailing address

218 Broadway Blvd SE
Albuquerque, NM 87102-3425
Phone (505) 242-6988

Other identifiers 1

IdentifierTypeStateIssuer
87423251MedicaidNM

National Provider Directory

National Provider Directory

Locations

218 Broadway Blvd SE
Albuquerque, NM 87102
Phone (505) 242-6988

Practitioners & affiliated clinicians

Practitioners 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1285801191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 BROADWAY BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023425",
            "telephone_number": "505-242-6988",
            "fax_number": "505-242-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 BROADWAY BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023425",
            "telephone_number": "505-242-6988",
            "fax_number": "505-242-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVOLUTION GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-242-6988",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87423251",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.