The Evergreens

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE EVERGREENS

Practice address

309 Bridgeboro Road
Moorestown, NJ 08057

Phone

(410) 778-7300

Fax

(410) 778-0053

NPI assigned

Nov 15, 2018

Organization subpart

No

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

Authorized official

Name

Susan Ahern

Title

SVP, Cfo

Phone

(215) 661-8330

Specialties & licenses 1

Addresses

Other names 1

• Primary Care Services at The Evergreens Doing business as

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1457820847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE DR",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342711",
            "telephone_number": "267-787-4097",
            "fax_number": "215-699-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 BRIDGEBORO ROAD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "410-778-7300",
            "fax_number": "410-778-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVERGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "215-661-8330"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Services at The Evergreens",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Primary Care Services at The Evergreens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.