Johnson Evergreen Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2081-C Issued in CT

Legal business name

JOHNSON EVERGREEN CORPORATION

Practice address

205 Chestnut Hill Rd
Stafford Springs, CT 06076-4005

Phone

(860) 684-8714

Fax

(860) 684-8723

NPI assigned

Aug 23, 2006

Last updated

May 14, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Anna Romanowski

Title

Director of Reimbursement

Phone

(860) 684-8714

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Evergreen Health Care Center Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Briggs, APRN

  • Gerontology Nurse Practitioner
  • Somers, CT
  • NPI 1255878773
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1053427609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CHESTNUT HILL RD",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060764005",
            "telephone_number": "860-684-8714",
            "fax_number": "860-684-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CHESTNUT HILL RD",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060764005",
            "telephone_number": "860-684-8714",
            "fax_number": "860-684-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON EVERGREEN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "ROMANOWSKI",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "860-684-8714",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2081-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000020529",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "833",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A3796830",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "44044",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE PROVIDER NUM",
            "identifier": "712385",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Health Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ryan Gelinas, PA
• Scott E Harrison, PA
• Christopher Hunt, LO
• Natalie Imbier, LNM
• Taylor Nicole Jackson
• Johnson Medical Specialists, PC
• Johnson Memorial Hospital, Inc.
• Johnson Memorial Hospital, Inc.
• Johnson Memorial Hospital, Inc.
• Johnson Professional Associates, PC

• Skilled Nursing Facility in Stafford Springs, CT
• Providers in Stafford Springs, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.