Active NPI
Angela K Evans, D.C.
- Chiropractor
- Sandpoint, ID
National Provider Identifier
1346352515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-1038
- Practice address
- 1205 Highway 2 Ste 101
Sandpoint, ID 83864-2740 - Phone
- (208) 265-0743
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-1038 | ID | Primary |
Addresses
Primary practice location
1205 Highway 2 Ste 101
Sandpoint, ID 83864-2740
Mailing address
1205 Highway 2 Ste 101
Sandpoint, ID 83864-2740
Phone (208) 265-0743
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010144223 | Other | ID | BLUE SHIELD |
| 870395551 | Other | ID | CHP |
| C3639 | Other | ID | BLUE CROSS |
| 5485361 | Other | ID | CCN |
| 806677900 | Medicaid | ID |
Other names 1
- Angela K. Goodwin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040109000035 | ID | Practitioner - Chiropractic | 3971403833 | Practice locations: Sandpoint, ID |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1038 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1346352515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 HIGHWAY 2 STE 101",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838642740",
"telephone_number": "208-265-0743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 HIGHWAY 2 STE 101",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838642740",
"telephone_number": "208-265-0743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "ANGELA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-1038",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010144223",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHP",
"identifier": "870395551",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "C3639",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCN",
"identifier": "5485361",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806677900",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "GOODWIN",
"middle_name": "K.",
"credential": "D.C.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.