NPIMap

Organization Active NPI

Evergreen Physical Therapy Limited Partnership

  • Physical Therapist
  • Big Rapids, MI
National Provider Identifier
1730126285
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVERGREEN PHYSICAL THERAPY LIMITED PARTNERSHIP
Practice address
1268 Perry Ave
Big Rapids, MI 49307-2115
Phone
(231) 796-4419
Fax
(231) 796-4980
NPI assigned
Jun 1, 2006
Last updated
Nov 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Authorized official

Name
Janna P. King, JD
Title
VP, Authorized Official
Phone
(713) 297-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1268 Perry Ave
Big Rapids, MI 49307-2115

Mailing address

1300 W Sam Houston Pkwy S
Suite 300
Houston, TX 77042-2447
Phone (713) 297-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070516000180 MI Part B Supplier - Clinic/Group Practice 7618074220 Receives reassigned benefits from 12 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Big Rapids, MI; Clare, MI; Gladwin, MI; Harrison, MI; Midland, MI

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Evergreen PT Partnership4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1268 Perry Ave
Big Rapids, MI 49307
Phone (231) 796-4419

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1730126285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422447",
            "telephone_number": "713-297-7000",
            "fax_number": "713-297-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 PERRY AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072115",
            "telephone_number": "231-796-4419",
            "fax_number": "231-796-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PHYSICAL THERAPY LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JANNA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VP, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.