Evergreen Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

EVERGREEN DERMATOLOGY LLC

Practice address

21 Hayden Bridge Way
Springfield, OR 97477-1305

Phone

(541) 600-2017

NPI assigned

Feb 10, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Lindsey Fix, MDNPI 1972913259

Title

Physician

Phone

(252) 561-5558

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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

• Lindsey Fix, M.D.

  • MOHS-Micrographic Surgery Physician
  • Springfield, OR
  • NPI 1972913259

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Jordan C Cook, DO

  • Dermatology Physician
  • Springfield, OR
  • NPI 1588041719
  Medicare reassignment Care Compare group NPD
• Eric G Olson, M.D.

  • Specialist
  • Springfield, OR
  • NPI 1275531865
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1477207272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771305",
            "telephone_number": "541-600-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771305",
            "telephone_number": "541-600-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "FIX",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-561-5558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker-Leigh Evans, NP
• Paul E Evans, M.D.
• Tianna Christine Evans
• Frances Everett, PH.D.
• Rolanda R Everett, MD
• Evergreen Vascular Consultants
• Jenna Joann Everson
• Joshua Evert, LMT
• William Carlton Everts, DO
• Ronald K Ewert, DDS

• Dermatology Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.