Evolution Physical Therapy & Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EVOLUTION PHYSICAL THERAPY & WELLNESS

Practice address

130 W Berryhill Dr
Grass Valley, CA 95945-5835

Phone

(530) 205-9538

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Miranda Smith

Title

Practice Manager

Phone

(530) 205-9538

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Steve Crandall, PT

  • Physical Therapist
  • Grass Valley, CA
  • NPI 1013356831
  Medicare reassignment NPD
• Evan Ariel Walters

  • Orthopedic Physical Therapist
  • Grass Valley, CA
  • NPI 1184114779
  Medicare reassignment NPD
• Garrett M. Eckerling, M.D.

  • Family Medicine Physician
  • Grass Valley, CA
  • NPI 1215937388
  NPD (past)

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1568053742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W BERRYHILL DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455835",
            "telephone_number": "530-205-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W BERRYHILL DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455835",
            "telephone_number": "530-205-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PHYSICAL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "530-205-9538"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Evans
• Brian Evans, M.D.
• Gayle Ann Evans, RN
• Paul Lewis Evans, D.D.S.
• Richard F. Evans, MD
• Evolution Physical Therapy & Wellness LLC (Evolution Physical Therapy and Wellness)
• Gwendolyn P. Eymann, RN-NP
• Crystal Jean Wheeler Ezell, SLP
• Antoinette Belinda Fabela, M.A
• Anabel S Facemire, MD

• Physical Therapist in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.