The Evergreens Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0236 Issued in NC

Legal business name

THE EVERGREENS INC.

Practice address

206 Greensboro Rd
High Point, NC 27260-3456

Phone

(336) 886-4121

Fax

(336) 886-6285

NPI assigned

Jul 28, 2006

Last updated

Nov 15, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James A Newman Jr., LNHA

Title

Administrator

Phone

(336) 886-4121

Specialties & licenses 2

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1487668216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 GREENSBORO RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272603456",
            "telephone_number": "336-886-4121",
            "fax_number": "336-886-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 GREENSBORO RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272603456",
            "telephone_number": "336-886-4121",
            "fax_number": "336-886-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVERGREENS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-886-4121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "NH0236",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "00830",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405178",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAID PCS PROVIDER NO",
            "identifier": "7801625",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PROVIDER NUMBER",
            "identifier": "23497",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406161",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Cast Enhancement
• The Community Clinic of High Point, Inc.
• The Community Clinic of High Point, Inc.
• The Discovery Place of High Point, NC
• The Ecclesiastes House, LLC
• The Faith-Courage House, LLC
• The House of Charity, LLC
• The JRS Bliss Group
• The Mental Health Association in North Carolina, Inc. (Edgewood Group Home)
• The Mental Health Association in North Carolina, Inc. (Brentwood Home)

• Skilled Nursing Facility in High Point, NC
• Providers in High Point, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.