Evolved, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH-4071 Issued in AZ

Legal business name

EVOLVED, LLC

Practice address

4905 E 29TH St
Tucson, AZ 85711-6445

Phone

(910) 212-2261

Fax

(520) 704-6072

NPI assigned

Dec 13, 2012

Organization subpart

No

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

Authorized official

Name

Dennis Todd Shepard Jr.

Title

Cfo

Phone

(910) 212-2261

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1780920033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 E 29TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857116445",
            "telephone_number": "910-212-2261",
            "fax_number": "520-704-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 E 29TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857116445",
            "telephone_number": "910-212-2261",
            "fax_number": "520-704-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-212-2261",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-4071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles S. Everts, MD
• Evo MD PLLC
• Evo Solutions Youth&Family Services
• Evolve Physical Therapy & Sports Performance
• Evolve Wellness
• Julie Ann Ewing, PH.D.
• Sharon Ewing, FNP
• Gordon A Ewy, MD
• Excel Physical Therapy
• Excel Psychiatric Care PLLC

• Community/Behavioral Health Agency in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.