Evolve Therapy LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

EVOLVE THERAPY LLC

Practice address

18 Oliver St Suite 101
Newark, NJ 07102

Phone

(862) 272-7504

Fax

(862) 206-8417

NPI assigned

Feb 17, 2020

Organization subpart

No

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

Authorized official

Name

Eder Charles, MS OTR/L

Title

Owner

Phone

(862) 272-7504

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1922631100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 OLIVER ST SUITE 101",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "862-272-7504",
            "fax_number": "862-206-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 OLIVER ST SUITE 101",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "862-272-7504",
            "fax_number": "862-206-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "EDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-272-7504",
        "authorized_official_credential": "MS OTR/L"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Health RX LLC
• Heather B. Evers, CPNP
• Joan Everson, APN
• Everyday Services and Transportation LLC
• Evidence Transportation and Logistics
• Glen Martin Ewing, GRNA
• Ewr Medport
• James Exilus
• Leshelle Exilus
• Exousia Home Care LLC

• Occupational Therapist in Newark, NJ
• Providers in Newark, NJ by specialty
• Occupational Therapist in New Jersey

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