NPIMap

Organization Active NPI

Evans Chiropractic Center Inc

  • Chiropractor
  • New Milford, PA
National Provider Identifier
1447280623
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC04995L Issued in PA
Legal business name
EVANS CHIROPRACTIC CENTER INC
Practice address
182 Main St
New Milford, PA 18834-2114
Phone
(570) 465-3444
Fax
(570) 465-5400
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gerald David Evans, DCNPI 1689663676
Title
Owner
Phone
(570) 465-3444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC04995L PA Primary

Addresses

Primary practice location

182 Main St
New Milford, PA 18834-2114

Mailing address

182 Main St
PO Box 484
New Milford, PA 18834-2114
Phone (570) 465-3444

Other identifiers 3

IdentifierTypeStateIssuer
0012964820002MedicaidPA
511796OtherPABLUE SHIELD
836180OtherPAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080307000033 PA Part B Supplier - Clinic/Group Practice 6709961345 Receives reassigned benefits from 2 practitioners
Practice locations: New Milford, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447280623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 MAIN ST",
            "address_2": "PO BOX 484",
            "city": "NEW MILFORD",
            "state": "PA",
            "postal_code": "188342114",
            "telephone_number": "570-465-3444",
            "fax_number": "570-465-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 MAIN ST",
            "city": "NEW MILFORD",
            "state": "PA",
            "postal_code": "188342114",
            "telephone_number": "570-465-3444",
            "fax_number": "570-465-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-465-3444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC04995L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012964820002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "511796",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "836180",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, PA

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.