NPIMap

Organization Active NPI

Evolve Chiropractic PLLC

  • Chiropractor
  • Mountainhome, PA
National Provider Identifier
1992159701
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011126 Issued in PA
Legal business name
EVOLVE CHIROPRACTIC PLLC
Practice address
1101 Route 390
Suite 3
Mountainhome, PA 18342
Phone
(570) 856-1242
NPI assigned
Apr 18, 2016
Last updated
Apr 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Authorized official

Name
Dr. Derek E Gorman, D.C.NPI 1427417567
Title
Chiropractor
Phone
(570) 856-1242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011126 PA Primary

Addresses

Primary practice location

1101 Route 390
Suite 3
Mountainhome, PA 18342

Mailing address

211 Krummel LN
Cresco, PA 18326-7051
Phone (570) 856-1242

National Provider Directory

National Provider Directory

Locations

1101 Route 390
#103
Cresco, PA 18326
Phone (570) 481-6060

Practitioners & affiliated clinicians

Practitioners 1

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": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1992159701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 KRUMMEL LN",
            "city": "CRESCO",
            "state": "PA",
            "postal_code": "183267051",
            "telephone_number": "570-856-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ROUTE 390",
            "address_2": "SUITE 3",
            "city": "MOUNTAINHOME",
            "state": "PA",
            "postal_code": "18342",
            "telephone_number": "570-856-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "570-856-1242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainhome, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.