Evenstar Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34645 Issued in CO

Legal business name

EVENSTAR INTERNAL MEDICINE PC

Practice address

6165 Lehman Dr Ste 105
Colorado Springs, CO 80918-5405

Phone

(719) 528-6929

Fax

(719) 528-6900

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Trudy G Wong, MD

Title

President

Phone

(719) 528-6929

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396967097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 LEHMAN DR STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185405",
            "telephone_number": "719-528-6929",
            "fax_number": "719-528-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6165 LEHMAN DR STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185405",
            "telephone_number": "719-528-6929",
            "fax_number": "719-528-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVENSTAR INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-528-6929",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "34645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15874273",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda N Evanson, RBT
• William Albert Eveland III, D.M.D.
• Elora A Even
• Michele Marie Even, RN, MSN
• Lisa Evensky-Stark, LCSW
• Ever Evolving Counseling
• Evercare Medequip LLC
• Rachel Everett, B.A.
• Ralph E. Everett, M.D.
• Evergreen Chinese Medicine LLC

• Internal Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.