NPIMap

Organization Active NPI

George M. Wolverton M.D. Inc.

Doing business as Evergreen Medical Centre

  • Family Medicine Physician
  • Jeffersonville, IN
National Provider Identifier
1962421990
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50000563 Issued in IN
Legal business name
GEORGE M. WOLVERTON M.D. INC.
Doing business as
Evergreen Medical Centre
Practice address
300 Spring St Ste 3B
Jeffersonville, IN 47130-3498
Phone
(812) 282-4309
Fax
(812) 283-8299
NPI assigned
Jul 19, 2006
Last updated
Apr 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Authorized official

Name
Dr. Steven Mitchell Johnson, D.O.NPI 1760406466
Title
Medical Doctor
Phone
(812) 282-4309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 50000563 IN Primary

Addresses

Primary practice location

300 Spring St Ste 3B
Jeffersonville, IN 47130-3498

Mailing address

8009 Weyanoke CT
Prospect, KY 40059-9426
Phone (502) 292-0428

Other names 1

  • Evergreen Medical Centre Doing business as

National Provider Directory

National Provider Directory

Locations

647 Eastern Blvd
Clarksville, IN 47129
Phone (812) 282-4309

300 Spring St
Ste 3B
Jeffersonvlle, IN 47130
Phone (812) 282-4309

Practitioners & affiliated clinicians

Practitioners 6

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1962421990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8009 WEYANOKE CT",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599426",
            "telephone_number": "502-292-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SPRING ST STE 3B",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303498",
            "telephone_number": "812-282-4309",
            "fax_number": "812-283-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE M. WOLVERTON M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "812-282-4309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "50000563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Medical Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.