Individual provider Active NPI

John Bryant Evans, D.C.

  • Chiropractor
  • Murrells Inlet, SC
National Provider Identifier
1295704575
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2672 Issued in SC
Practice address
658 Wachesaw Rd
Murrells Inlet, SC 29576-5631
Phone
(843) 357-9617
Fax
(843) 357-9639
NPI assigned
Mar 17, 2006
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2672 SC Primary

Addresses

Primary practice location

658 Wachesaw Rd
Murrells Inlet, SC 29576-5631

Mailing address

658 Wachesaw Rd
Murrells Inlet, SC 29576-5631
Phone (843) 357-9617

Other identifiers 1

IdentifierTypeStateIssuer
GCH459MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625000206 SC Practitioner - Chiropractic 4486630035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waccamaw Chiroipractic and Wellness CenterGroup PAC ID 5597741140, 2 clinicians

Practice addresses (Care Compare)

658 Wachesaw Rd
Murrells Inlet, SC 29576-5631
Phone (843) 357-9617

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2672SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Waccamaw Chiroipractic & Wellness Center Chiropractor CurrentSince Mar 19, 2004 Accepting new patients

Locations

658 Wachesaw Rd
Murrells Inlt, SC 29576
Phone (843) 357-9617

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1295704575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 WACHESAW RD",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765631",
            "telephone_number": "843-357-9617",
            "fax_number": "843-357-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 WACHESAW RD",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765631",
            "telephone_number": "843-357-9617",
            "fax_number": "843-357-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH459",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.