EVERGREEN OREGON HEALTHCARE INDEPENDENCE, L.L.C. (NPI# 1497703201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497703201 |
| Entity Type | Organization |
| Organization Name | EVERGREEN OREGON HEALTHCARE INDEPENDENCE, L.L.C. |
| Other Organization Name | INDEPENDENCE HEALTH AND REHABILITATION CENTER |
| Practice Address |
1525 Monmouth St Independence OR 97351-1007 |
| Mailing Address |
4601 Ne 77th Ave Suite 300 Vancouver WA 98662-6736 |
| Practice Telephone | 5038380001 |
| Practice Fax Number | 5038387826 |
| Mailing Telephone | 3608926628 |
| Mailing Fax Number | 3608825793 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2017-01-30 |
| Authorized Official Name | BRENT WEIL (CEO AND MANAGER) |
| Authorized Official Telephone | 3608926628 |
| Is Organization Subpart | Y |
| Parent Organization Name | EMPRES OREGON HEALTHCARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1663 | OR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 801030 | 05 |
| Other Name | Type Code |
|---|---|
| Independence Health and Rehabilitation Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | EVERGREEN OREGON HEALTHCARE INDEPENDENCE, L.L.C. | 1525 Monmouth, Independence, OR 97351 |
| Street Address |
1525 MONMOUTH ST |
| City | INDEPENDENCE |
| State | OR |
| Zip Code | 97351-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518127844 | David Patrick Mcdarby | Physical Therapist | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1881854115 | Bobbi Jo Shrum | Physical Therapy Assistant | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598868515 | Independence-monmouth Family Medicine PC | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| 1821070111 | Kenneth R Winokur | Dentist | 329 South Main St, Independence, OR 97351 | 2005-11-14 |
| 1710044144 | Kenneth R Winokur Dmd PC | Dentist | 329 S Main St, Independence, OR 97351 | 2007-01-03 |
| 1407959422 | Keith Allen White | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| 1609901024 | Evan L Evans | Audiologist | 1343 A Monmouth St, Independence, OR 97351-0248 | 2007-02-23 |
| 1639426208 | Central School District 13j | Local Education Agency (LEA) | 1610 Monmouth St, Independence, OR 97351-1008 | 2012-08-13 |
| 1851645931 | Holli Watkin | Nurse Practitioner | 1601 Monmouth St Ste 100, Independence, OR 97351-1019 | 2012-10-29 |
| 1699394585 | Jennifer Elizabeth O'sullivan | Specialist/Technologist | 1369 Monmouth St, Independence, OR 97351-1126 | 2020-04-10 |
| 1336108711 | Independence Pharmacy, Inc | Pharmacy | 1357 Monmouth St, Independence, OR 97351-1126 | 2006-03-22 |
| 1033105317 | Paul D Turgesen | Dentist | 1335 Monmouth St, Independence, OR 97351-1126 | 2005-09-22 |
| Find all providers in zip 97351 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114451648 | Sunterra Independence Oc, LLC | Skilled Nursing Facility | 19200 E 37th Terrace S, Independence, MO 64057-8324 | 2017-04-11 |
| 1023247806 | 325th Combat Support Hospital | Skilled Nursing Facility | 11101 E Independence Ave, Independence, MO 64054-1511 | 2009-07-14 |
| 1255436556 | Independence Manor Inc | Skilled Nursing Facility | 1600 S Kings Highway, Independence, MO 64055 | 2006-09-13 |
| 1841393782 | Carmel Hills Healthcare and Rehabilitation Center, LLC | Skilled Nursing Facility | 810 East Walnut, Independence, MO 64050 | 2006-09-06 |
| 1750305033 | Grayson Facility Operations, LLC | Skilled Nursing Facility | 400 S. Independence Avenue, Independence, VA 24348-3857 | 2006-07-27 |
| 1932132750 | Independence 1 Inc | Skilled Nursing Facility | 10300 E Truman Rd, Independence, MO 64052-2258 | 2006-07-07 |
| 1457396426 | Sp Grayson, LLC | Skilled Nursing Facility | 400 S Independence Ave, Independence, VA 24348-3857 | 2006-06-16 |
| 1104877695 | Ggnsc Independence II LLC | Skilled Nursing Facility | 17451 Medical Center Pkwy, Independence, MO 64057-1805 | 2006-05-12 |
| 1992792923 | Regency Care Center of Independence, L.c. | Skilled Nursing Facility | 1800 S Swope Dr, Independence, MO 64057-1084 | 2005-10-04 |
| 1588666127 | Abcm Corporation | Skilled Nursing Facility | 1610 3rd St Ne, Independence, IA 50644-2228 | 2005-08-12 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 97351 |
Please comment or provide details below to improve the information on EVERGREEN OREGON HEALTHCARE INDEPENDENCE, L.L.C..
| 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.