NPIMap

Organization Active NPI

Evolved Incorporated

  • Chiropractor
  • Reno, NV
National Provider Identifier
1780425645
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EVOLVED INCORPORATED
Practice address
800 W 2ND St Unit 100
Reno, NV 89503-5696
Phone
(775) 870-9654
NPI assigned
Jun 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Dr. Nicole Hickok, DCNPI 1083080626
Title
Owner/Director
Phone
(775) 870-9654

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 Primary

Addresses

Primary practice location

800 W 2ND St Unit 100
Reno, NV 89503-5696

Mailing address

800 W 2ND St Unit 100
Reno, NV 89503-5696
Phone (775) 870-9654

Other practice location 1

1408 Boydstun Loop
McCall, ID 83638-3409
Phone (775) 870-9654

Other identifiers 1

IdentifierTypeStateIssuer
1083080626MedicaidNV

Other names 1

  • Evolve Chiropractic Boutique Doing business as

National Provider Directory

National Provider Directory

Locations

800 W 2nd St
Unit 100
Reno, NV 89503
Phone (775) 376-0327

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": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1780425645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 2ND ST UNIT 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895035696",
            "telephone_number": "775-870-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 2ND ST UNIT 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895035696",
            "telephone_number": "775-870-9654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1408 Boydstun Loop",
            "address_purpose": "LOCATION",
            "city": "McCall",
            "state": "ID",
            "postal_code": "836383409",
            "country_code": "US",
            "telephone_number": "775-870-9654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVED INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "HICKOK",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "775-870-9654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083080626",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Chiropractic Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolve Chiropractic Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.