Organization Active NPI

Evergreen Healthcare Clinic Limited Liability Company

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1831039395
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
EVERGREEN HEALTHCARE CLINIC LIMITED LIABILITY COMPANY
Practice address
300 N Charles St Ste D
Baltimore, MD 21201-4305
Phone
(240) 644-5570
NPI assigned
Apr 1, 2026
Last updated
Jul 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Yvette LedjoNPI 1972954139
Title
Owner
Phone
(240) 644-5570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

300 N Charles St Ste D
Baltimore, MD 21201-4305

Mailing address

13707 Crownsgate Way
Germantown, MD 20874-4424

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Healthcare Clinic Limited Liability Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1775001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1831039395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 CROWNSGATE WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208744424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N CHARLES ST STE D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014305",
            "telephone_number": "240-644-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HEALTHCARE CLINIC LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "LEDJO",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-644-5570"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.