Organization Active NPI

Duke Equities LLC

  • Skilled Nursing Facility
  • Rome, GA
National Provider Identifier
1285199430
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DUKE EQUITIES LLC
Practice address
139 Moran Lake Rd NE
Rome, GA 30161-7767
Phone
(706) 378-3383
NPI assigned
Feb 1, 2019
Last updated
Feb 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Authorized official

Name
Lisa Landers
Title
Manager
Phone
(706) 378-3383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

139 Moran Lake Rd NE
Rome, GA 30161-7767

Mailing address

139 Moran Lake Rd NE
Rome, GA 30161-7767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190607001099 GA Part A Provider - Skilled Nursing Facility 9830422708 Practice locations: Rome, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285199430. Details of each certification follow.

Skilled nursing facility certification: CCN 115720

Legal name
DUKE EQUITIES LLC
Doing business as
EVERGREEN HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 31, 2008
Last certification
Aug 18, 2024
Beds
100
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jan 4, 2019 in GA
Enrollment address
139 Moran Lake Rd NE
Rome, GA 30161-7767
Nursing home name
EVERGREEN HEALTH AND REHABILITATION CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Evergreen Health and Rehabilitation CenterCCN 115720 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 31, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10085.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1086593Evergreen Health and Rehabilitation Center139 Moran Lake Road, Rome, GA 30161Certificate of waiverJul 15, 2028

National Provider Directory

National Provider Directory

Locations

139 Moran Lake Rd NE
Rome, GA 30161
Phone (706) 291-8212

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lisa Landers Individual Corporate OfficerManager of the LLC Mar 16, 2019 100%
W-2 Managing EmployeeAdministrator Mar 16, 2019
Operational/Managerial ControlManager of the LLC Mar 16, 2019
Prince Equities LLC Organization, Rome, GA Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Jan 4, 2019 100%
Operational/Managerial Control Mar 16, 2019

Practitioners & affiliated clinicians

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1285199430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 MORAN LAKE RD NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301617767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 MORAN LAKE RD NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301617767",
            "telephone_number": "706-378-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUKE EQUITIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "LANDERS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "706-378-3383"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.