EVOLVE CHIROPRACTIC LLC — NPI 1790440006 (Licensed & Credentialed Chiropractic Providers

CMS-1500 Box 24J / 33a • NPI

1790440006

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

111N00000X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor

Box 32 Service Location & ZIP+4

918 MAIN ST, LEXINGTON, MO, 64067-1343

✓ 9-Digit EDI 837 ZIP+4 (64067-1343)

Practice Phone & Referral Fax

(660) 251-4055

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1790440006 (EVOLVE CHIROPRACTIC LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1790440006` (NPI-2 Organization / Facility)
Provider / Legal Name	EVOLVE CHIROPRACTIC LLC
Plain-English Specialty	Licensed & Credentialed Chiropractic Providers — Chiropractor NUCC Code: `111N00000X` (Chiropractor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	918 MAIN ST, LEXINGTON, MO, 64067-1343
Practice Telephone / Fax	Tel: (660) 251-4055
Administrative Mailing Address	PO BOX 476, LEXINGTON, MO, 64067-0476
Enumeration & Last Sync	Enumerated: 2021-11-02 \| CMS Record Updated: 2021-12-28
Authorized Official	STEPHANIE WILLIAMS-BOGUSKIE (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

918 MAIN ST, LEXINGTON, MO, 64067-1343

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Plain-English Taxonomy & CMS Crosswalk (111N00000X)

What Does Taxonomy Code 111N00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111N00000X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Chiropractor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EVOLVE CHIROPRACTIC LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`111N00000X` — Chiropractor Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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EVOLVE CHIROPRACTIC LLC (NPI #1790440006)