NPIMap

Organization Active NPI

Evergreen Health and Wellness, LLC

  • Registered Dietitian
  • Kearney, MO
National Provider Identifier
1982383048
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
EVERGREEN HEALTH AND WELLNESS, LLC
Practice address
14919 Plattsburg Rd
Kearney, MO 64060-8155
Phone
(207) 838-5549
NPI assigned
Jul 17, 2023
Last updated
Aug 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Johannah A Schrader, RD, LD, CDCESNPI 1225581812
Title
Owner/Registered Dietitian
Phone
(207) 838-5549

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary
Obesity and Weight Management Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1201X
Sports Dietetics Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1501X
Community Health Clinic/Center 261QC1500X

Addresses

Primary practice location

14919 Plattsburg Rd
Kearney, MO 64060-8155

Mailing address

14919 Plattsburg Rd
Kearney, MO 64060-8155
Phone (207) 838-5549

Other practice location 1

100 E 6th St Ste 3
Kearney, MO 64060-8631
Phone (816) 200-2442

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1982383048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14919 PLATTSBURG RD",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640608155",
            "telephone_number": "207-838-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14919 PLATTSBURG RD",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640608155",
            "telephone_number": "207-838-5549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E 6th St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Kearney",
            "state": "MO",
            "postal_code": "640608631",
            "country_code": "US",
            "telephone_number": "816-200-2442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVERGREEN HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "SCHRADER",
        "authorized_official_first_name": "JOHANNAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "207-838-5549",
        "authorized_official_credential": "RD, LD, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.