EVERGREEN NURSING & REHABILITATION CARE CENTER
NPI 1245237965
Skilled Nursing Facility in Modesto, CA
NPI Status: Active since July 07, 2005
Contact Information
2030 EVERGREEN AVE
MODESTO, CA
ZIP 95350
Phone: (209) 577-1055
Fax: (209) 550-3619
- Organization
- Skilled Nursing Facility
About EVERGREEN NURSING & REHABILITATION CARE CENTER
This page provides the complete NPI Profile along with additional information for Evergreen Nursing & Rehabilitation Care Center, a provider established in Modesto, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1245237965 assigned on July 2005. The practitioner's primary taxonomy code is 314000000X with license number 100000038 (CA). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Evergreen Nursing & Rehabilitation Care Center. The authorized official of this NPI record is Mr. Benedict V. Cipponeri Jr. (Chief Executive Officer)
- NPI
- 1245237965
- Provider Legal Name
- EVERGREEN CONVALESCENT HOSPITAL AND REHABILITATION CENTER, INC.
- Other Organization Name
- EVERGREEN NURSING & REHABILITATION CARE CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2030 EVERGREEN AVE MODESTO, CA 95350
- Location Phone
- (209) 577-1055
- Location Fax
- (209) 550-3619
- Mailing Address
- 2030 EVERGREEN AVE MODESTO, CA 95350
- Mailing Phone
- (209) 577-1055
- Mailing Fax
- (209) 550-3619
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-07-2005
- Last Update Date
- 05-21-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 100000038
- License State
- CA
- Taxonomy Description
- (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 13676588 | OTHER (01) | CA | STATE-COMP |
| 555118 | MEDICARE OSCAR/CERTIFICATION (06) | CA | |
| ZZR55118F | MEDICAID (05) | CA | |
| 0390550001 | MEDICARE NSC (07) | CA |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 4 | 5 | 2 | 3 | 7 | 9 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 8 | 5 | 4 | 3 | 14 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 8 + 5 + 4 + 3 + 1 + 4 + 9 + 1 + 2 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1245237965 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1285016188 | WINDSOR MODESTO HEALTHCARE, LLC Organization | Skilled Nursing Facility | 2030 EVERGREEN AVE MODESTO, CA 95350 (209) 577-1055 |
| 1699237958 | LISA MARIE RIOS COTA/L Individual | Occupational Therapy Assistant | 2030 EVERGREEN AVE MODESTO, CA 95350 (209) 577-1055 |
| 1457058588 | KIONA LAKAYLA JOHNSON COTA Individual | Occupational Therapy Assistant | 2030 EVERGREEN AVE MODESTO, CA 95350 (209) 577-1055 |
| 1255938015 | NEWPORT LLC. Organization | Skilled Nursing Facility | 2030 EVERGREEN AVE MODESTO, CA 95350 (916) 899-1315 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245237965, enumerated in the NPI registry as an "organization" on July 07, 2005
The provider is located at 2030 Evergreen Ave Modesto, Ca 95350 and the phone number is (209) 577-1055
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on July 07, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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