Active NPI
Keith Alan Evans, D.C.
- Chiropractor
- Beaumont, TX
National Provider Identifier
1992704688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5213
- Practice address
- 4220 Treadway Rd
Beaumont, TX 77706-7105 - Phone
- (409) 833-5600
- Fax
- (409) 833-2111
- NPI assigned
- Jul 15, 2005
- Reactivated
- Apr 3, 2006
- Last updated
- Jun 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5213 | TX | Primary |
Addresses
Primary practice location
4220 Treadway Rd
Beaumont, TX 77706-7105
Mailing address
9898 Colonnade Blvd
#17202
San Antonio, TX 78230-2247
Phone (409) 781-1668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5213 | TX | MD | Behavioral Analyst |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276646400000",
"number": "1992704688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9898 COLONNADE BLVD",
"address_2": "#17202",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782302247",
"telephone_number": "409-781-1668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 TREADWAY RD",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777067105",
"telephone_number": "409-833-5600",
"fax_number": "409-833-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "KEITH",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-15",
"last_updated": "2010-06-16",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "5213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.