Evergreen at Tracy, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100000285 Issued in CA

Legal business name

EVERGREEN AT TRACY, L.L.C.

Practice address

2586 Buthmann Ave
Tracy, CA 95376-2165

Phone

(209) 832-2273

Fax

(209) 832-0743

NPI assigned

May 4, 2006

Organization subpart

Yes

Parent organization

EMPRES CALIFORNIA HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Brent Weil

Title

Ceo and Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New Hope Post Acute Care Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pranjalkumar H Patel, M.D.

  • Family Medicine Physician
  • Tracy, CA
  • NPI 1225233133
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1316995152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626736",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2586 BUTHMANN AVE",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953762165",
            "telephone_number": "209-832-2273",
            "fax_number": "209-832-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN AT TRACY, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPRES CALIFORNIA HEALTHCARE, LLC",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO AND MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "100000285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55245I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Hope Post Acute Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Giselle Estrada
• Katie Estrada
• Roderick L. Estrada, MD
• Danielle Etcheverry
• Coral A Evans
• Maja Michelle Everson, MD
• Evolve Family Therapy PC
• Fadli Home Care Inc
• Patrick Victor Faggianelli Jr., PH.D.
• Maria Faheem

• Skilled Nursing Facility in Tracy, CA
• Providers in Tracy, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.