Evolution Chiropractic and Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EVOLUTION CHIROPRACTIC AND WELLNESS

Practice address

947 E Winding Creek Dr Ste 200
Eagle, ID 83616-7231

Phone

(503) 756-5317

NPI assigned

Dec 7, 2021

Last updated

Dec 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Payne, DCNPI 1427213693

Title

President

Phone

(208) 917-2928

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeremy Lamont Payne, DC

  • Naturopath
  • Eagle, ID
  • NPI 1427213693

  Chiropractor

  NPD Authorized official
• Sergey Kashubin, NP-C

  • Primary Care Nurse Practitioner
  • Boise, ID
  • NPI 1912569351
  NPD
• Susan Ann Steiner, FNP

  • Family Nurse Practitioner
  • Meridian, ID
  • NPI 1740250596
  NPD

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1801554852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 E WINDING CREEK DR STE 200",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167231",
            "telephone_number": "503-756-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 E WINDING CREEK DR STE 200",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167231",
            "telephone_number": "503-756-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-917-2928",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTPID015388",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enhanced Aesthetics and Wellness
• Evan Hathaway DDS PA
• Lyndsey Evans
• Roger Evenson, LCSW-44535
• Evergreen Psychology & Wellness, LLC
• Evolution Joint Pain Clinic
• Eye 2 Eye PLLC
• Family & Functional Medicine of Idaho PLLC
• Family Life Counseling Center LLC (Family Life Counseling Center)
• Robbie El Fattal, BCBA-D, LBA

• Chiropractor in Eagle, ID
• Providers in Eagle, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.