NPIMap

Organization Active NPI

Evergreen Natural Health Solutions

Doing business as Evergreen Chiropractic

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1417096256
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1153 Issued in ID
Legal business name
EVERGREEN NATURAL HEALTH SOLUTIONS
Doing business as
Evergreen Chiropractic
Practice address
1640 W Cherry LN
130
Meridian, ID 83642-1321
Phone
(208) 895-8595
Fax
(208) 895-8594
NPI assigned
Feb 6, 2007
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Matthew David Hales, D.C.NPI 1295742690
Title
Owner
Phone
(208) 895-8595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIA-1153 ID Primary

Addresses

Primary practice location

1640 W Cherry LN
130
Meridian, ID 83642-1321

Mailing address

1640 W Cherry LN
130
Meridian, ID 83642-1321
Phone (208) 895-8595

Other names 1

  • Evergreen Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1417096256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 W CHERRY LN",
            "address_2": "130",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421321",
            "telephone_number": "208-895-8595",
            "fax_number": "208-895-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 W CHERRY LN",
            "address_2": "130",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421321",
            "telephone_number": "208-895-8595",
            "fax_number": "208-895-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN NATURAL HEALTH SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "HALES",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-895-8595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.