Evergreen Valley Nursing Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

0901301N Issued in NY

Legal business name

EVERGREEN VALLEY NURSING HOME

Practice address

8 Bushey Blvd
Plattsburgh, NY 12901-3761

Phone

(518) 563-3261

Fax

(518) 562-1367

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Michele Byno

Title

Administrator

Phone

(518) 563-3261

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HASSETT ADULT DAY SERVICES Doing business as

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316033152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BUSHEY BLVD",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013761",
            "telephone_number": "518-563-3261",
            "fax_number": "518-562-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 BUSHEY BLVD",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013761",
            "telephone_number": "518-563-3261",
            "fax_number": "518-562-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN VALLEY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BYNO",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "518-563-3261"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NY",
            "license": "0901301N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02329757",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HASSETT ADULT DAY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua David Escoe, DPT
• Amr Essa, MD
• Aaron Esterson, MD
• Cheryl Jasmin Eustaquio, M.D.
• Debra Everett
• Evergreen Valley Nursing Home
• Charles A Everly, M.D.
• Phoebe L Everson, MD
• Eye Care for the Adirondacks Associates in Ophthalmology PC
• Eye Care for the Adirondacks Associates in Ophthalmology, PC

• Adult Care Home Facility in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Adult Care Home Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.