NPIMap

Organization Active NPI

Evershine Care LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Las Cruces, NM
National Provider Identifier
1427775584
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
EVERSHINE CARE LLC
Practice address
4846 Calle Bella Ave
Las Cruces, NM 88012-7066
Phone
(443) 854-4727
NPI assigned
Oct 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Dr. Ivan NwaoguNPI 1285041731
Title
Administrator
Phone
(443) 854-4727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

4846 Calle Bella Ave
Las Cruces, NM 88012-7066

Mailing address

4844 Calle Bella Ave
Las Cruces, NM 88012-7066
Phone (575) 382-5973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427775584. Details of each certification follow.

  • CCN 32G065 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 32G065

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Evershine Care-Calle Bella 2
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 22, 2023
Last certification
Jul 22, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
4846 Calle Bella Avenue
Las Cruces, NM 88012

National Provider Directory

National Provider Directory
Tax ID family
Evershine Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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.

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1427775584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4844 CALLE BELLA AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880127066",
            "telephone_number": "575-382-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4846 CALLE BELLA AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880127066",
            "telephone_number": "443-854-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSHINE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "NWAOGU",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "443-854-4727",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.