Evergreen at Foothills, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-2640 Issued in AZ

Legal business name

EVERGREEN AT FOOTHILLS, L.L.C.

Practice address

15810 S 42ND St
Phoenix, AZ 85048-7409

Phone

(480) 759-0358

Fax

(480) 759-7666

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Andrew V. Martini

Title

Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evergreen Foothills Health and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437107281",
    "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": "986626729",
            "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": "15810 S 42ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487409",
            "telephone_number": "480-759-0358",
            "fax_number": "480-759-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN AT FOOTHILLS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-892-6628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-2640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842965",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Foothills Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamara Lynn Even, COTA
• Everbloom Integrated Services PLLC
• Everest Medical Solutions, LLC
• Helen Carol Everett, PHARM D
• James L Everett, M.D.
• Evergreen Home Care, LLC
• Jennifer Everhart, LPN
• Kara Kristin Marie Everhart
• Diana Everitt, R.N.
• Everlast Hospice Care Inc.

• Skilled Nursing Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Skilled Nursing Facility in Arizona

• 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.