Evergreen Eye MDS LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EVERGREEN EYE MDS LLC

Practice address

330 N Chestnut St
Ravenna, OH 44266-2287

Phone

(503) 901-1531

NPI assigned

Feb 10, 2025

Organization subpart

No

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

Authorized official

Name

Paul Kurz, MDNPI 1063417152

Title

Sole Member

Phone

(503) 901-1531

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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

• Paul Allen Kurz, MD

  • Ophthalmology Physician
  • Ravenna, OH
  • NPI 1063417152
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1952116642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662287",
            "telephone_number": "503-901-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN EYE MDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "KURZ",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "503-901-1531",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Etz
• Terrah Roes Eudy, RN, BSN
• April Evans, LPC
• Ever Well Community Health
• Ryan Oliver Everett
• Fadi Abbass MD
• Mackenzie Mae Fadorsen
• Christine Marie Faler, PT
• Family & Community Services, Inc
• Farris Homecare, LLC

• Ophthalmology Physician in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.