Organization Active NPI

Evans Chiropractic, LLC

  • Chiropractor
  • Hamilton, NJ
National Provider Identifier
1629388434
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC0053800 Issued in NJ
Legal business name
EVANS CHIROPRACTIC, LLC
Practice address
3679 Nottingham Way Ste a
Hamilton, NJ 08690-2611
Phone
(609) 586-9199
Fax
(609) 586-5766
NPI assigned
Oct 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Dr. Eric T Evans, D.C.NPI 1093867392
Title
Owner
Phone
(609) 392-5001

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 38MC0053800 NJ Primary

Addresses

Primary practice location

3679 Nottingham Way Ste a
Hamilton, NJ 08690-2611

Mailing address

3679 Nottingham Way Ste a
Hamilton, NJ 08690-2611
Phone (609) 586-9199

Other identifiers 1

IdentifierTypeStateIssuer
1D6205500MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110302000495 NJ Part B Supplier - Clinic/Group Practice 3375724941 Receives reassigned benefits from 1 practitioner
Practice locations: Hamilton, NJ

National Provider Directory

National Provider Directory

Locations

688 Haddon Ave
Collingswood, NJ 08108
Phone (609) 392-5001

30 S Warren St
#1
Trenton, NJ 08608
Phone (609) 392-5001

3679 Nottingham Way
#A
Trenton, NJ 08690
Phone (609) 586-9199

Practitioners & affiliated clinicians

Practitioners 2

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": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1629388434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3679 NOTTINGHAM WAY STE A",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086902611",
            "telephone_number": "609-586-9199",
            "fax_number": "609-586-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3679 NOTTINGHAM WAY STE A",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086902611",
            "telephone_number": "609-586-9199",
            "fax_number": "609-586-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-392-5001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC0053800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1D6205500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.