# EVOLUTION JOINT PAIN CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932871985
- **Authorized official:** JEREMY LAMONT PAYNE ND, DC (MEMBER)
- **Authorized official phone:** (208) 917-2928

## Contact information

- **Practice address:** 951 E PLAZA DR STE 170, EAGLE, ID 83616-6569
- **Practice address phone:** (208) 917-2928
- **Mailing address:** 951 E PLAZA DR STE 170, EAGLE, ID 83616-6569
- **Mailing address phone:** (208) 917-2928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 175F00000X | Naturopath | — | NULL | Yes |
| 175F00000X | Naturopath | — | — | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 09/29/2021
- **Last updated:** 08/18/2026