NPIMap

Organization Active NPI

Evolution Psychiatric and Mental Health Services, LLC

Doing business as Evolution Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gainesville, FL
National Provider Identifier
1972262699
Registry record updated Jan 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EVOLUTION PSYCHIATRIC AND MENTAL HEALTH SERVICES, LLC
Doing business as
Evolution Health
Practice address
1204 NW 69TH Ter Ste B
Gainesville, FL 32605-3139
Phone
(352) 575-3600
Fax
(352) 641-9592
NPI assigned
Dec 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2024

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

Authorized official

Name
Aijay Richards, APRN, PMHNP
Title
Pmhnp
Phone
(352) 575-3600

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1204 NW 69TH Ter Ste B
Gainesville, FL 32605-3139

Mailing address

1204 NW 69TH Ter Ste B
Gainesville, FL 32605-3139
Phone (352) 575-3600

Other names 1

  • Evolution Health Doing business as

National Provider Directory

National Provider Directory

Locations

5550 NW 111th Blvd
Gainesville, FL 32653
Phone (352) 204-3657

1204 NW 69th Ter
Ste B
Gainesville, FL 32605
Phone (352) 378-9090

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706400000000",
    "number": "1972262699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 NW 69TH TER STE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326053139",
            "telephone_number": "352-575-3600",
            "fax_number": "352-559-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 NW 69TH TER STE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326053139",
            "telephone_number": "352-575-3600",
            "fax_number": "352-641-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PSYCHIATRIC AND MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-09",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "AIJAY",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "352-575-3600",
        "authorized_official_credential": "APRN, PMHNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolution Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; 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.