Evergreen Medical and Nursing Inc

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

Legal business name

EVERGREEN MEDICAL AND NURSING INC

Practice address

4471 Gina St
Fremont, CA 94538-2857

Phone

(408) 887-0534

NPI assigned

Apr 5, 2025

Organization subpart

No

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

Authorized official

Name

Gloria E FolloscoNPI 1174145940

Title

Owner

Phone

(408) 887-0534

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Gloria E Follosco

  • Family Nurse Practitioner
  • Fremont, CA
  • NPI 1174145940
  Medicare reassignment NPD Authorized official
• Kusum Regmi, FNP

  • Family Nurse Practitioner
  • Campbell, CA
  • NPI 1538705611
  Medicare reassignment NPD

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1629862701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 GINA ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382857",
            "telephone_number": "408-887-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4471 GINA ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382857",
            "telephone_number": "408-887-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MEDICAL AND NURSING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "FOLLOSCO",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-887-0534"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Home Administrator in Fremont, CA
• Providers in Fremont, CA by specialty
• Nursing Home Administrator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.