Evolve Healthcare Corp.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EVOLVE HEALTHCARE CORP.

Practice address

2908 Wayne Ave
Kansas City, MO 64109-1629

Phone

(816) 617-8787

NPI assigned

Jul 23, 2024

Last updated

Jul 31, 2024By 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

Iman Boudreaux

Title

Executive Director

Phone

(816) 617-8787

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1326876111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 WAYNE AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641091629",
            "telephone_number": "816-617-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 WAYNE AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641091629",
            "telephone_number": "816-617-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE HEALTHCARE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "IMAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "816-617-8787"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Jul 31, 2024; 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.