Evergreen Healing Center, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EVERGREEN HEALING CENTER, LLC

Practice address

224 State St
Bangor, ME 04401-3434

Phone

(207) 512-0584

Fax

(207) 990-6604

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Laura Tremaine Bridgman, FNPNPI 1043315658

Title

Family Nurse Practitioner

Phone

(207) 512-0584

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 2

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

• Laura T. Bridgman, F.N.P., N.D.

  • Family Nurse Practitioner
  • Dixmont, ME
  • NPI 1043315658
  Medicare reassignment NPD Authorized official
• Marianne Fricke, LCSW

  • Social Worker
  • Bangor, ME
  • NPI 1295895340
  NPD (past)

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1578892147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 COTTRELL RD",
            "city": "DIXMONT",
            "state": "ME",
            "postal_code": "049323246",
            "telephone_number": "207-512-0584",
            "fax_number": "207-234-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013434",
            "telephone_number": "207-512-0584",
            "fax_number": "207-990-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "BRIDGMAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "TREMAINE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "207-512-0584",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ME",
            "license": "AP081246",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246520000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather S Evans, DO
• Tona Lynn Evans, LADC-CCS
• Everest PC
• Evergreen Assisted Living, LLC
• Evergreen Gynecology Associates, P.a.
• Jenny Everhart, LMSW-CC
• Everhaven LLC
• Everkind Care LLC
• Evernorth Care Providers - Delaware PA
• Adrienne Miranda Ewer, FNP

• Family Nurse Practitioner in Bangor, ME
• Providers in Bangor, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.