NPIMap

Organization Active NPI

Evergreen Manor Senior Care Centre, LLC

Doing business as Evergreen Senior Care and Rehab Center

  • Skilled Nursing Facility
  • Springfield, MI
National Provider Identifier
1992855316
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
134160 Issued in MI
Legal business name
EVERGREEN MANOR SENIOR CARE CENTRE, LLC
Doing business as
Evergreen Senior Care and Rehab Center
Practice address
111 Evergreen Rd
Springfield, MI 49037-7417
Phone
(269) 969-6110
Fax
(269) 969-6710
NPI assigned
Jan 10, 2007
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Todd Sangster
Title
Cfo
Phone
(810) 534-0150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 134160 MI Primary
Nursing Facility Supplies (DME) 332BN1400X 134160 MI

Addresses

Primary practice location

111 Evergreen Rd
Springfield, MI 49037-7417

Mailing address

10503 Citation Dr Ste 100
Brighton, MI 48116-6551
Phone (810) 534-0150

Other identifiers 3

IdentifierTypeStateIssuer
4406078MedicaidMI
0A30320OtherMIBCBS DME P&O
09903OtherMIBCBSM

Other names 1

  • Evergreen Senior Care and Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111026000180 MI Part A Provider - Skilled Nursing Facility 1254545643 Practice locations: Springfield, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992855316. Details of each certification follow.

Skilled nursing facility certification: CCN 235054

Legal name
EVERGREEN MANOR SENIOR CARE CENTRE, LLC
Doing business as
EVERGREEN SENIOR CARE AND REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Jan 15, 2025
Beds
91
Ownership / control type
Corporation
Multi-facility organization
Nexcare Wellbridge
Organization structure
LLCProprietary
Incorporated
Apr 1, 2002 in MI
Enrollment address
111 Evergreen Rd
Springfield, MI 49037-7417
Nursing home name
EVERGREEN MANOR SENIOR CARE CENTER
Affiliated entity
NEXCARE HEALTH SYSTEMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Evergreen Manor Senior Care CenterCCN 235054 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9188.4 residents per day on average
Chain
Nexcare Health Systems20 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0676107Evergreen Senior Care and Rehab111 Evergreen Road, Springfield, MI 49037Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Branscum Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2013 31%
Nexcare Health Systems, LLC Organization, Brighton, MI LLC Operational/Managerial Control Oct 6, 2011 10%
Michael D Perry Individual Operational/Managerial Control Aug 1, 2015
Todd M Sangster Individual Corporate Officer Nov 4, 2013
Robin Eisenberg 2014 Family Trust Organization, Farmington Hills, MI 5% Or Greater Indirect Ownership Interest Apr 1, 2014 31%
Nexcare Holdings, LLC Organization, Brighton, MI LLC 5% Or Greater Direct Ownership Interest Nov 1, 2013 100%
Leo Eisenberg Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2014 31%
Cheryl Smith Individual W-2 Managing Employee Jul 7, 2016
Frank M Wronski Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2014 31%

Facilities with the same owner 27

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 27

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1992855316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10503 CITATION DR STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166551",
            "telephone_number": "810-534-0150",
            "fax_number": "810-534-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EVERGREEN RD",
            "city": "SPRINGFIELD",
            "state": "MI",
            "postal_code": "490377417",
            "telephone_number": "269-969-6110",
            "fax_number": "269-969-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MANOR SENIOR CARE CENTRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "SANGSTER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "810-534-0150"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "134160",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "MI",
            "license": "134160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4406078",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DME P&O",
            "identifier": "0A30320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "09903",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Senior Care and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Senior Care and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MI

Sources for this page

Verify at the official NPI Registry.