EVERGREEN NURSING HOME, LLC (NPI# 1285693762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285693762 |
| Entity Type | Organization |
| Organization Name | EVERGREEN NURSING HOME, LLC |
| Practice Address |
100 Sanders Dr Evergreen AL 36401-3306 |
| Mailing Address |
501 Whetstone St Monroeville AL 36460-2615 |
| Practice Telephone | 2515783783 |
| Practice Fax Number | 2515783786 |
| Mailing Telephone | 2517433609 |
| Mailing Fax Number | 2515755618 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID G MCABEE (CFO) |
| Authorized Official Telephone | 2517433609 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 12509 | AL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 4750890S | 05 |
| Street Address |
100 SANDERS DR |
| City | EVERGREEN |
| State | AL |
| Zip Code | 36401-3306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437347572 | Elizabeth L Godwin | Counselor | 101 Perryman Street Hwy 31, Compass Academy, Evergreen, AL 36401 | 2007-10-12 |
| 1679691661 | Floyd Michael Cartwright | Dentist | 122 Court Street, Evergreen, AL 36401 | 2007-03-27 |
| 1467526038 | Evergreen Dental Center | Dentist | 100 Edwina Street, Evergreen, AL 36401 | 2006-11-17 |
| 1134141229 | Michael L Pitts | Physical Therapist | 124 Edwina St, Evergreen, AL 36401 | 2006-07-24 |
| 1275565442 | Mark A Roberts | Family Medicine | 106 Edwina Street, Evergreen, AL 36401 | 2006-07-07 |
| 1881677581 | Evergreen Medical Center LLC | Registered Nurse | 308 South Main St, Evergreen, AL 36401 | 2005-11-28 |
| 1063918118 | Jessica Roberts Pierce | Nurse Practitioner | 106 Edwina Street, Evergreen, AL 36401 | 2018-04-05 |
| 1962535112 | Douglas Patrick O'connor | Dentist | 104 Hillcrest Dr, Evergreen, AL 36401 | 2007-03-14 |
| 1952466211 | Mark A Roberts Md PC | Family Medicine | 106 Edwina Street, Evergreen, AL 36401 | 2006-12-27 |
| 1659540086 | State of Alabama | Public Health or Welfare | Highway 83 and I-65, Evergreen, AL 36401-0565 | 2008-02-29 |
| Find all providers in zip 36401 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467998864 | Advance Med | Nursing Facility/Intermediate Care Facility | 117 Rocky Ridge St, Carrollton, AL 35447-2139 | 2017-01-10 |
| 1568863785 | Mobile Picc Specialists | Nursing Facility/Intermediate Care Facility | 39 Ashwood Rd, Butler, AL 36904-2860 | 2014-09-07 |
| 1740552306 | Oakwoods Dream Care Assisted Living Facility LLC. | Nursing Facility/Intermediate Care Facility | 1008 Oakwood Ave Nw, Huntsville, AL 35811-1661 | 2012-01-29 |
| 1609077577 | Rtg Medical | Nursing Facility/Intermediate Care Facility | 400 N Ash Ave, Demopolis, AL 36732-2444 | 2007-05-30 |
| 1861597114 | Jackson County Healthcare Authority | Nursing Facility/Intermediate Care Facility | 47065 Alabama Hwy 277, Bridgeport, AL 35740 | 2006-09-13 |
| 1154380632 | Crowne Health Care of Mobile, LLC | Nursing Facility/Intermediate Care Facility | 954 Navco Rd, Mobile, AL 36605-2413 | 2006-03-22 |
| 1508825076 | Crowne Health Care of Fort Payne, LLC | Nursing Facility/Intermediate Care Facility | 403 13th St Nw, Fort Payne, AL 35967-3145 | 2006-03-22 |
| 1043279532 | Crowne Health Care of Eufaula, LLC | Nursing Facility/Intermediate Care Facility | 430 Rivers Ave, Eufaula, AL 36027-1820 | 2006-03-22 |
| 1659330132 | Parkwood Health Care Facility, LLC | Nursing Facility/Intermediate Care Facility | 3301 Stadium Dr, Phenix City, AL 36867-3115 | 2006-03-22 |
| 1740249200 | Atmore Nursing Center, LLC | Nursing Facility/Intermediate Care Facility | 715 E Laurel St, Atmore, AL 36502-3113 | 2006-03-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.