Essex Healthcare Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1513N Issued in OH

Legal business name

ESSEX HEALTHCARE CORPORATION

Doing business as

Evergreen Manor Nursing Home

Practice address

924 Charlies Way
Montpelier, OH 43543-1904

Phone

(419) 485-8307

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Keith James Yoder

Title

Cfo

Phone

(614) 416-2662

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evergreen Manor Nursing Home Doing business as

Locations

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760583272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EASTON OVAL",
            "address_2": "SUITE 300",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196061",
            "telephone_number": "614-416-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 CHARLIES WAY",
            "city": "MONTPELIER",
            "state": "OH",
            "postal_code": "435431904",
            "telephone_number": "419-485-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSEX HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-416-2662"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1513N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033758",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Manor Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Dingess
• Matthew Dingess
• Darlene Doan
• Essex Healthcare Corp
• Essex Healthcare Corporation
• Rex A Good
• Heather M Harris, RN
• Heart at Home Compassion Care LLC
• Abigail Hilll, DC
• Deia Lynn Hutchinson

• Skilled Nursing Facility in Montpelier, OH
• Providers in Montpelier, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.