Evergreen Hospice, LLC.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

EVERGREEN HOSPICE, LLC.

Practice address

1930 S Alma School Rd Ste C104
Mesa, AZ 85210-3067

Phone

(480) 845-8182

Fax

(480) 590-0653

NPI assigned

Sep 28, 2021

Organization subpart

No

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

Authorized official

Name

Kathryne Baya

Title

Administrator

Phone

(480) 878-8918

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1669143798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 S ALMA SCHOOL RD STE C104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103067",
            "telephone_number": "480-845-8182",
            "fax_number": "480-590-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S ALMA SCHOOL RD STE C104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103067",
            "telephone_number": "480-845-8182",
            "fax_number": "480-590-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HOSPICE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "BAYA",
        "authorized_official_first_name": "KATHRYNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-878-8918"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WELLSKY",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1930 S Alma School Rd Ste C104",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852103067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sue Thayer Everett, MA CCC SLP
• Tarynn Francis Everett, PA-C
• Willie Everett
• Evergreen at Mesa (Alf), L.L.C. (Mesa Christian Residential Care Center)
• Evergreen at Mesa, L.L.C. (Evergreen Valley Health and Rehabilitation Center)
• Evergreen Mesa Christian, L.L.C. (Evergreen Mesa Christian Health and Rehabilitation Center)
• Evergrove Integrative Health PLLC
• Every Smile Mesa, LLC
• Evmark Corp (Extended Family Assisted Living Homes)
• Evolution Healthcare Management LLC

• Community Based Hospice Care Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.