Active NPI
Evergreen Living Innovations, Inc.
Doing business as Evergreen Community of Johnson County
- Skilled Nursing Facility
- Olathe, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- N046029
- Legal business name
- EVERGREEN LIVING INNOVATIONS, INC.
- Doing business as
- Evergreen Community of Johnson County
- Practice address
- 11875 S Sunset Dr Ste 100
Olathe, KS 66061-2794 - Phone
- (913) 477-8227
- Fax
- (913) 477-8001
- NPI assigned
- Jan 15, 2007
- Last updated
- Apr 8, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. K J Langlais
- Title
- Chief Executive Officer
- Phone
- (913) 477-8227
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | N046029 | KS | Primary |
Addresses
Primary practice location
11875 S Sunset Dr Ste 100
Olathe, KS 66061-2794
Mailing address
11875 S Sunset Dr Ste 100
Olathe, KS 66061-2794
Phone (913) 477-8227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100451870A | Medicaid | KS |
Other names 1
- Evergreen Community of Johnson County
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030401000021 | KS | Part A Provider - Skilled Nursing Facility | 8022927102 | Practice locations: Olathe, KS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1356492649. Details of each certification follow.
Skilled nursing facility certification: CCN 175355
- Legal name
- EVERGREEN LIVING INNOVATIONS INC
- Doing business as
- EVERGREEN COMMUNITY OF JOHNSON COUNTY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1996
- Last certification
- May 1, 2024
- Beds
- 44
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 11875 S Sunset Dr
Ste 100
Olathe, KS 66061-2794 - Nursing home name
- EVERGREEN COMMUNITY OF JOHNSON COUNTY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Evergreen Community of Johnson County
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 1, 1996
- Medicare certification status
- Active
- Certified beds
- 44
- Penalties (3 years)
- 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0886466 | Evergreen Community of Johnson County | Certificate of waiver | May 18, 2028 |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Ownership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Chris Holland | Corporate Officer | Aug 19, 2019 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Linda Gallagher | Corporate Director | Aug 20, 2020 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Patrick Amos | Corporate Officer | Jan 1, 2022 | |
| Dianne Daugherty | Corporate Director | Oct 1, 2018 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Jessica Dupriest | Corporate Officer | Jan 1, 2024 | |
| Mark Kevin Dwyer | Corporate Director | Jan 1, 2024 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Charla Roberts | Corporate Officer | Oct 9, 2023 | |
| Operational/Managerial Control | Oct 9, 2023 | ||
| Adp of the SNF | Oct 9, 2023 | ||
| Mark Gash | Corporate Director | Apr 1, 2018 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Brett a Parise | Corporate Director | Jan 1, 2022 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Mary Gash | Corporate Director | Oct 18, 2018 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Andrea Plowman | Corporate Officer | Jan 1, 2024 | |
| Christopher M Osborn | Corporate Officer | May 1, 2011 | |
| Debra Swearingen-Lyles | Corporate Director | Apr 23, 2024 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Evergreen Living Innovations Inc | 5% Or Greater Direct Ownership Interest | Jan 1, 2003 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Physical Therapist
- Louisburg, KS
- NPI 1518719392
Corporate Director, Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Evergreen Hospice Care LLC | Hospice | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 9, 2014 Dec 9, 2014 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Olathe, KS
- NPI 1356749527
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Olathe, KS
- NPI 1356749527
Evergreen Living Innovations Inc
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Community Based Hospice Care Agency
- Olathe, KS
- NPI 1356749527
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Lee's Summit, MO
- NPI 1194179747
-
- Family Medicine Physician
- Lee's Summit, MO
- NPI 1346627049
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- Lee's Summit, MO
- NPI 1346627049
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1239148800000",
"number": "1356492649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11875 S SUNSET DR STE 100",
"city": "OLATHE",
"state": "KS",
"postal_code": "660612794",
"telephone_number": "913-477-8227",
"fax_number": "913-477-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11875 S SUNSET DR STE 100",
"city": "OLATHE",
"state": "KS",
"postal_code": "660612794",
"telephone_number": "913-477-8227",
"fax_number": "913-477-8001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN LIVING INNOVATIONS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-15",
"last_updated": "2009-04-08",
"status": "A",
"authorized_official_last_name": "LANGLAIS",
"authorized_official_first_name": "K",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "913-477-8227",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KS",
"license": "N046029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100451870A",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Evergreen Community of Johnson County",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.