NPIMap

Organization Active NPI

Evergreen Medical Group, LLC

  • Neurology Chiropractor
  • Coral Springs, FL
National Provider Identifier
1811291305
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CH4871 Issued in FL
Legal business name
EVERGREEN MEDICAL GROUP, LLC
Practice address
5944 Coral Ridge Dr # 138
Coral Springs, FL 33076-3300
Phone
(954) 415-8253
NPI assigned
Dec 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Dr. Jordan H. Jordan, D.C.
Title
MNGR.
Phone
(954) 415-8253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X CH4871 FL Primary

Addresses

Primary practice location

5944 Coral Ridge Dr # 138
Coral Springs, FL 33076-3300

Mailing address

5944 Coral Ridge Dr # 138
Coral Springs, FL 33076-3300
Phone (954) 415-8253

National Provider Directory

National Provider Directory

Locations

5944 Coral Ridge Dr
Coral Springs, FL 33076
Phone (954) 415-8253

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1811291305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5944 CORAL RIDGE DR # 138",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763300",
            "telephone_number": "954-415-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5944 CORAL RIDGE DR # 138",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763300",
            "telephone_number": "954-415-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MNGR.",
        "authorized_official_telephone_number": "954-415-8253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH4871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.