Evan Philip Mladenoff Jr., D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

01-05771 Issued in KS

Practice address

11021 Metcalf Ave
Overland Park, KS 66210

Phone

(913) 491-1071

Fax

(913) 451-8566

NPI assigned

Nov 15, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Johnson Chiropractic & Acupuncture P.a.

  • Chiropractor
  • Overland Park, KS
  • NPI 1396881512
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1902348485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11021 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-491-1071",
            "fax_number": "913-451-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-491-1071",
            "fax_number": "913-451-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLADENOFF",
        "first_name": "EVAN",
        "middle_name": "PHILIP",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "KS",
            "license": "01-05771",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "KS",
            "license": "01-05771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Marie Mize, PHARMD
• Brendon Lee Mizner, PT, DPT
• Benyamine Mizrahi, M.D.
• Diana Vasselle Mladenoff, DC
• Evan Mladenoff, D.C.
• Mmjones Services
• Mo Kan Hearing Innovations LLC
• Mobile Anesthesia Care, LLC
• Mobile Dental Management, Inc.
• Mobile Health Clinics, LLC

• Sports Physician Chiropractor in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Sports Physician Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.