EVERGREEN HEALTH CARE CENTER
NPI 1053427609
Skilled Nursing Facility in Stafford Springs, CT

Active since August 23, 2006CLIA 07D0861583 · Waiver
205 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076(860) 684-8714(860) 684-8723 Get Directions Write a Review

NPPES record last updated: May 14, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreen Health Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN HEALTH CARE CENTER (NPI 1053427609) is a healthcare organization registered as a skilled nursing facility in Stafford Springs, Connecticut and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Anna Romanowski, Director Of Reimbursement, as its authorized official.

NPPES Registry Identity

NPI1053427609
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameJOHNSON EVERGREEN CORPORATION
Location Address205 CHESTNUT HILL RDStafford Springs, CT 06076-4005
Mailing Address205 Chestnut Hill RdStafford Springs, CT 06076-4005 · (860) 684-8714 · Fax (860) 684-8723
Fax(860) 684-8723
Organization SubpartNo
Authorized OfficialAnna RomanowskiDirector Of Reimbursement · (860) 684-8714
Enumeration DateAugust 23, 2006
Last NPPES UpdateMay 14, 2015
NPI 1053427609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CT · 2081-C
Definition
(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.
205 CHESTNUT HILL RD, Stafford Springs, CT 06076

Other Names 1

Other NameEvergreen Health Care Center

Other Identifiers 6

Other833CT · Anthem Blue Cross Blue Shield
OtherA3796830CT · Oxford
Other44044CT · Wellcare
Other712385CT · Connecticare Provider Num
Medicaid000020529CT
Medicare OSCAR/certification075326CT

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D0861583

Evergreen Health Care Center · Stafford Springs, CT
Active · expires Aug 31, 2026
CLIA Number07D0861583
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDushyant B. Parikh MD
Laboratory Phone(860) 684-6341
Laboratory LocationEvergreen Health Care Center205 Chestnut Hill Rd, Stafford Springs, CT 06076
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
205 CHESTNUT HILL RD
STAFFORD SPRINGS, CT 06076
Skilled Nursing Facility
205 CHESTNUT HILL RD
STAFFORD SPRINGS, CT 06076
Skilled Nursing Facility
205 CHESTNUT HILL RD
STAFFORD SPRINGS, CT 06076
Physical Therapist
205 CHESTNUT HILL RD
STAFFORD SPRINGS, CT 06076

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnson Evergreen Corporation's NPI number?

The NPI number for Johnson Evergreen Corporation is 1053427609. It was assigned to this organization in the NPPES registry on August 23, 2006. The provider is also known as Evergreen Health Care Center.

Where is Johnson Evergreen Corporation located?

Johnson Evergreen Corporation is located at 205 Chestnut Hill Rd, Stafford Springs, CT 06076. The listed phone number is (860) 684-8714.

What is Johnson Evergreen Corporation's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Johnson Evergreen Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D0861583) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Johnson Evergreen Corporation was last updated on May 14, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.