Evergreen Senior Healthcare of Maine, LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

EVERGREEN SENIOR HEALTHCARE OF MAINE, LLC

Practice address

108 Anthony Ave
Augusta, ME 04330-8089

Phone

(207) 872-8992

Fax

(207) 430-3565

NPI assigned

May 22, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Leann Sebrey, RN

Title

Chief Operating Officer

Phone

(207) 542-0770

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Renee Folk, NP

  • Family Nurse Practitioner
  • Augusta, ME
  • NPI 1013343342
  Medicare reassignment NPD
• Leah D Hayes, FNP

  • Family Nurse Practitioner
  • Augusta, ME
  • NPI 1902775299
  Medicare reassignment NPD
• Dominique A Uva, FNP-C

  • Family Nurse Practitioner
  • Elmira, NY
  • NPI 1316351133

  ME

  Medicare reassignment NPD

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1841039583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ANTHONY AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308089",
            "telephone_number": "207-872-8992",
            "fax_number": "207-430-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ANTHONY AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308089",
            "telephone_number": "207-872-8992",
            "fax_number": "207-430-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SENIOR HEALTHCARE OF MAINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "SEBREY",
        "authorized_official_first_name": "LEANN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "207-542-0770",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navid Eslami, MD
• Eugene H. Glad D.M.D. P.a.
• Ashlyn Evans, FNP-C
• Megan Evans, NP
• Evergreen Dental Associates LLC
• Eyemart Express LLC
• Joshua Eyitemi, MD
• Amy Ezhaya, APRN
• Danielle Fabian
• Facial and Oral Surgery Associates

• Geriatric Medicine (Family Medicine) Physician in Augusta, ME
• Providers in Augusta, ME by specialty
• Geriatric Medicine (Family Medicine) Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.