EVERGREEN MANOR SENIOR CARE CENTRE, LLC (NPI# 1992855316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992855316 |
| Entity Type | Organization |
| Organization Name | EVERGREEN MANOR SENIOR CARE CENTRE, LLC |
| Other Organization Name | EVERGREEN SENIOR CARE AND REHAB CENTER |
| Practice Address |
111 Evergreen Rd Springfield MI 49037-7417 |
| Mailing Address |
10503 Citation Dr Ste 100 Brighton MI 48116-6551 |
| Practice Telephone | 2699696110 |
| Practice Fax Number | 2699696710 |
| Mailing Telephone | 8105340150 |
| Mailing Fax Number | 8105340208 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-11-16 |
| Authorized Official Name | RICHARD ANTHONY SCHERRER (OWNER) |
| Authorized Official Telephone | 8105340150 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
134160 | MI | Suppliers |
| Y | 314000000X | Skilled Nursing Facility | 134160 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 09903 | 01 |
| MI | 4406078 | 05 | |
| MI | BCBS DME P&O | 0A30320 | 01 |
| Other Name | Type Code |
|---|---|
| Evergreen Senior Care and Rehab Center | Doing Business As Name - Organization |
| Street Address |
111 EVERGREEN RD |
| City | SPRINGFIELD |
| State | MI |
| Zip Code | 49037-7417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316436942 | Kimberly Ann Sevastopoulos | Occupational Therapist | 111 Evergreen Rd, Springfield, MI 49037-7417 | 2018-05-09 |
| 1902244239 | Tammy Sue Cassel | Nurse's Aide | 111 Evergreen Rd, Springfield, MI 49037-7417 | 2013-06-09 |
| 1790928323 | Rebecca N King | Occupational Therapist | 111 Evergreen Rd, Springfield, MI 49037 | 2009-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053887570 | Kenneth Edward Newland Jr. | Physical Therapist | 165 N Washinton, Battle Creek, MI 49037 | 2018-10-23 |
| 1881177566 | Mary Jo E Moore | Occupational Therapist | Battle Creek Va Medical Center, 5500 Armstrong Rd, Battle Creek, MI 49037 | 2018-09-10 |
| 1255817680 | Jeremy Lynn Fuller | Nurse Practitioner | 5500 Armstron Rd, Battle Creek, MI 49037 | 2018-07-18 |
| 1043757180 | Brandee Millsap | Social Worker | 875 Washington N Ave, Battle Creek, MI 49037 | 2017-01-27 |
| 1649632944 | Amanda Marie Bean | Military Health Care Provider | 75 Phantom Ave, Battle Creek, MI 49037 | 2016-03-25 |
| 1982082574 | Heather Marie Remmert | Counselor | 155 Garfield Avenue, Battle Creek, MI 49037 | 2015-05-14 |
| 1811395445 | Catharine Cook | Counselor | 2775 W. Dickman Rd, Suite P-1, Battle Creek, MI 49037 | 2014-12-14 |
| 1790199743 | Shuyan Rofe | Dentist | 181 W. Emmett St., Battle Creek, MI 49037 | 2014-06-18 |
| 1962839951 | Amanda Hammond | Counselor | 155 Garfield Ave, Battle Creek, MI 49037 | 2013-10-04 |
| 1508103920 | Cheryl Ann Zimlich | Clinical Nurse Specialist | 5500 Armstrong Road (11c), Va Medical Center, Battle Creek, MI 49037 | 2013-01-04 |
| Find all providers in zip 49037 | ||||
| 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 |
|---|---|---|---|---|
| 1508373838 | Sunterra Springfield Oc, LLC | Skilled Nursing Facility | 4935 S National Ave, Springfield, MO 65810 | 2018-01-09 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1376054197 | Trilogy Healthcare Operations of Springfield II, LLC | Skilled Nursing Facility | 2900 Bechtle Avenue, Springfield, OH 45504 | 2017-10-19 |
| 1033559349 | Marquis Care | Skilled Nursing Facility | 25 U St, Springfield, OR 97477-2155 | 2013-07-01 |
| 1447592118 | Ojcc LLC | Skilled Nursing Facility | 3089 Old Jacksonville Rd, Springfield, IL 62704-6486 | 2013-03-20 |
| 1225310246 | Lutheran Retirement Center Association | Skilled Nursing Facility | 4101 W Iles Ave, Springfield, IL 62711-7051 | 2011-09-15 |
| 1073747077 | The Maples Health and Rehabilitation, LLC | Skilled Nursing Facility | 610 W Sunset St, Springfield, MO 65807-3696 | 2009-05-06 |
| 1104034289 | Capitol Care Center, LLC | Skilled Nursing Facility | 555 W Carpenter St, Springfield, IL 62702-4905 | 2007-05-20 |
| 1396862314 | Good Shepherd Village LLC | Skilled Nursing Facility | 422 N Burnett Rd, Springfield, OH 45503-4821 | 2007-03-23 |
| 1346374949 | Woodland Manor Limited Partnership | Skilled Nursing Facility | 2000 Villa Rd, Springfield, OH 45503-1761 | 2007-03-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 49037 |
Please comment or provide details below to improve the information on EVERGREEN MANOR SENIOR CARE CENTRE, LLC.
| 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.