Evergreen Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

23D1101213 Issued in MI

Legal business name

EVERGREEN DIAGNOSTICS

Practice address

2025 S Washington Ave
Suite 210
Lansing, MI 48910-0828

Phone

(517) 371-1111

Fax

(517) 371-1121

NPI assigned

Sep 8, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Thomas A Faulkner

Title

Director

Phone

(517) 371-1111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1649503855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S WASHINGTON AVE",
            "address_2": "SUITE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489100828",
            "telephone_number": "517-371-1111",
            "fax_number": "517-371-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S WASHINGTON AVE",
            "address_2": "SUITE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489100828",
            "telephone_number": "517-371-1111",
            "fax_number": "517-371-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "517-371-1111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D1101213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Evans
• Elizabeth Everett
• John David Everett, MD
• Evergreen Counseling and Wellness, LLC
• Evergreen Dental Center,PLLC
• Evergreen Therapy LLC
• Everlasting Homecare LLC
• Evolve Counseling & Holistic Wellness LLC
• Exclusive Physical Therapy Inc
• Eyemart Express

• Clinical Medical Laboratory in Lansing, MI
• Providers in Lansing, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.