Organization Active NPI

Evanston Chiropractic Center Inc.

  • Chiropractor
  • Evanston, WY
National Provider Identifier
1841526092
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
516 Issued in WY
Legal business name
EVANSTON CHIROPRACTIC CENTER INC.
Practice address
624 W Cheyenne Dr Ste 3
Evanston, WY 82930-5517
Phone
(307) 679-4429
Fax
(307) 789-4959
NPI assigned
Oct 22, 2009
Last updated
Jun 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Authorized official

Name
Dee DillreeNPI 1427026285
Title
Chiropractor
Phone
(307) 789-4957

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
Chiropractor 111N00000X 516 WY Primary

Addresses

Primary practice location

624 W Cheyenne Dr Ste 3
Evanston, WY 82930-5517

Mailing address

624 W Cheyenne Dr Ste 3
Evanston, WY 82930-5517
Phone (307) 789-4957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091207000691 WY Part B Supplier - Clinic/Group Practice 4880733609 Receives reassigned benefits from 2 practitioners
Practice locations: Evanston, WY

National Provider Directory

National Provider Directory

Locations

624 W Cheyenne Dr
Ste 3
Evanston, WY 82930
Phone (307) 679-4429

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1841526092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W CHEYENNE DR STE 3",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305517",
            "telephone_number": "307-789-4957",
            "fax_number": "307-789-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W CHEYENNE DR STE 3",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305517",
            "telephone_number": "307-679-4429",
            "fax_number": "307-789-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSTON CHIROPRACTIC CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "DILLREE",
        "authorized_official_first_name": "DEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "307-789-4957"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.