Individual provider Active NPI

Angela May Evagash, D.C.

  • Chiropractor
  • Kingsland, GA
National Provider Identifier
1669640694
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006651 Issued in GA
Practice address
575 E King Ave
Kingsland, GA 31548-6394
Phone
(912) 729-2900
Fax
(912) 729-2901
NPI assigned
Feb 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006651 GA Primary

Addresses

Primary practice location

575 E King Ave
Kingsland, GA 31548-6394

Mailing address

575 E King Ave
Kingsland, GA 31548-6394
Phone (912) 729-2900

Other identifiers 1

IdentifierTypeStateIssuer
000934678AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1669640694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E KING AVE",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486394",
            "telephone_number": "912-729-2900",
            "fax_number": "912-729-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E KING AVE",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486394",
            "telephone_number": "912-729-2900",
            "fax_number": "912-729-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVAGASH",
        "first_name": "ANGELA MAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "006651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000934678A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

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