Evenson Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1094 Issued in ID

Legal business name

EVENSON CHIROPRACTIC, LLC

Practice address

2205 Ironwood PL Ste B
Coeur D Alene, ID 83814-2487

Phone

(208) 769-4800

Fax

(208) 769-9977

NPI assigned

Jan 7, 2008

Last updated

Jan 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Thomas Evenson, DC

Title

Doctor/Owner

Phone

(208) 769-4800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1285819425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 IRONWOOD PL STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142487",
            "telephone_number": "208-769-4800",
            "fax_number": "208-769-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 IRONWOOD PL STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142487",
            "telephone_number": "208-769-4800",
            "fax_number": "208-769-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVENSON CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "EVENSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "208-769-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.