Evolution Physical Therapy & Wellness LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EVOLUTION PHYSICAL THERAPY & WELLNESS LLC

Practice address

130 W Berryhill Dr
Grass Valley, CA 95945-5835

Phone

(530) 205-9538

Fax

(530) 460-1841

NPI assigned

Mar 15, 2019

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

Other identifiers 1

Other names 1

• Evolution Physical Therapy and Wellness Doing business as

Electronic endpoints 1

Locations

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
  NPD (past)
• Garrett M. Eckerling, M.D.

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

  • Orthopedic Physical Therapist
  • Grass Valley, CA
  • NPI 1184114779
  NPD (past)

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1578022869",
    "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",
            "fax_number": "530-460-1841"
        },
        {
            "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",
            "fax_number": "530-460-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "27297",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "miranda@evolutionptwellness.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "130 W Berryhill Dr",
            "city": "Grass Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "959455835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Evolution Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolution Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• 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 Dec 14, 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.