EVERGREEN RETIREMENT COMMUNITY, INC. (NPI# 1588097810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588097810 |
| Entity Type | Organization |
| Organization Name | EVERGREEN RETIREMENT COMMUNITY, INC. |
| Other Organization Name | EVERGREEN AT HOME |
| Practice Address |
1125 N Westfield St Oshkosh WI 54902-3216 |
| Practice Telephone | 9202376205 |
| Practice Fax Number | 9209660334 |
| Mailing Telephone | 8446547600 |
| Mailing Fax Number | 9209660334 |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2017-07-25 |
| Authorized Official Name | MRS. PEGGY BELLIN (ADMINISTRATOR) |
| Authorized Official Telephone | 9202372140 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | EVERGREEN RETIREMENT COMMUNITY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 1186 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PTAN | 527321 | 01 |
| Other Name | Type Code |
|---|---|
| Evergreen At Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144213281 | Evergreen Retirement Community, Inc. | Skilled Nursing Facility | 1130 N Westfield St, Oshkosh, WI 54902-3217 | 2005-08-24 |
| Street Address |
1125 N WESTFIELD ST |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54902-3216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688363 | Grandpa Ray's Home Care Partners LLC | In Home Supportive Care | 1755 W 7th Avenue, Oshkosh, WI 54902 | 2020-04-22 |
| 1942866314 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1212 S Koeller St, Oshkosh, WI 54902 | 2019-05-11 |
| 1508299926 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1736 W. 9th Ave., Oshkosh, WI 54902 | 2013-08-21 |
| 1881971513 | Eric D Jachthuber | Pharmacist | 950 Koeller Rd, Oshkosh, WI 54902 | 2011-11-09 |
| 1912158148 | Jennifer L Daly | Registered Nurse | 648 West 5th Avenue, Oshkosh, WI 54902 | 2008-10-07 |
| 1093873028 | Phyllis Ann Pieplow | Registered Nurse | 2307 Doty St, Oshkosh, WI 54902 | 2006-12-04 |
| 1336210939 | Juliette P M Sterkens | Audiologist | 1820 West Pointe Drive, Fox Valley Hearing Ctr Inc, Oshkosh, WI 54902 | 2006-11-13 |
| 1043266927 | Christopher S. Mcfarlane | Dentist | 1875 West Pointe Dr., Oshkosh, WI 54902 | 2006-05-25 |
| 1285688192 | Theresa Lynn Petrick Gatchell | Optometrist | 1300 S Koeller Road, Oshkosh, WI 54902 | 2006-05-22 |
| 1558329821 | Teresa M Vanaacken | Physical Therapist | 300 S Koeller Street, Suite B, Oshkosh, WI 54902 | 2006-05-03 |
| Find all providers in zip 54902 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396873832 | Homemakers Inc. of Oshkosh | Home Health | 2020 W 9th Ave, Oshkosh, WI 54904-8072 | 2007-02-28 |
| 1386281285 | Badger Pura Vida LLC | Home Health | 601 S Main St, Oshkosh, WI 54902-6056 | 2019-12-10 |
| 1982024261 | Pl Caregiving D/b/a Right At Home | Home Health | 2100 Omro Rd, Suite H, Oshkosh, WI 54904-7746 | 2014-04-24 |
| 1003072091 | Res-care Wisconsin, Inc. | Home Health | 2020 W 9th Ave, Oshkosh, WI 54903-2128 | 2008-07-30 |
| 1790940328 | Homemakers Inc. of Oshkosh | Home Health | 2020 W 9th Ave, Oshkosh, WI 54904-8072 | 2008-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245561 | Comfort Care 4 U, LLC | Home Health | 7701 Mineral Point Rd Ste A, Madison, WI 53717-2027 | 2020-11-04 |
| 1639779754 | Wisconsin Independent Living Solutions LLC | Home Health | 817 Colton St, Waukesha, WI 53186-5126 | 2020-10-28 |
| 1821698341 | Jaqualynne Postuchow | Home Health | 8739 Smith St, Sayner, WI 54560-9696 | 2020-10-26 |
| 1467068767 | Lashonda Nicole Simmons | Home Health | 24th Street, 1812 North, Milwaukee, WI 53205-1410 | 2020-09-22 |
| 1124634332 | Nehemiah House, LLC | Home Health | 3901 N 21st Street, Milwaukee, WI 53206 | 2020-09-22 |
| 1699389593 | Infinity Care Services LLC | Home Health | 9203 W Bluemound Rd Ste A, Milwaukee, WI 53226-4484 | 2020-09-08 |
| 1982218426 | Homecare Pal, LLC | Home Health | 2916 Marketplace Dr Ste 209, Fitchburg, WI 53719-5327 | 2020-09-02 |
| 1366053118 | Adron Health Care, LLC | Home Health | 9117 S 20th St, Oak Creek, WI 53154-7465 | 2020-08-14 |
| 1790396521 | Faithful Living Home Health Care Agency LLC | Home Health | 3846 W Wisconsin Ave Apt 110, Milwaukee, WI 53208-3175 | 2020-08-14 |
| 1770194847 | Faithful Hands PCa LLC | Home Health | 8008 W Capitol Dr, Milwaukee, WI 53222-1918 | 2020-08-12 |
| Find all providers with the same taxonomy | ||||
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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.