EVERGREEN RETIREMENT COMMUNITY, INC.
NPI 1144213281
Skilled Nursing Facility in Oshkosh, WI
Overall Rating: 5 out of 5 stars
NPI Status: Active since August 24, 2005
Contact Information
1130 N WESTFIELD ST
OSHKOSH, WI
ZIP 54902
Phone: (920) 233-2340
Fax: (920) 237-2109
- Organization
- Skilled Nursing Facility
- Accepts Insurance
- CLIA Number: 52D0701379
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 08-31-2026
About EVERGREEN RETIREMENT COMMUNITY, INC.
This page provides the complete NPI Profile along with additional information for Evergreen Retirement Community, Inc., a provider established in Oshkosh, Wisconsin operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1144213281 assigned on August 2005. The practitioner's primary taxonomy code is 314000000X with license number 2057 (WI). The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Ms. Peggy F Bellin Rn (Health Center Administrator)
- NPI
- 1144213281
- Provider Name
- EVERGREEN RETIREMENT COMMUNITY, INC.
- Entity Type
- Organization
- Location Address
- 1130 N WESTFIELD ST OSHKOSH, WI 54902
- Location Phone
- (920) 233-2340
- Location Fax
- (920) 237-2109
- Mailing Address
- 1130 N WESTFIELD ST OSHKOSH, WI 54902
- Mailing Phone
- (920) 233-2340
- Mailing Fax
- (920) 237-2109
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-24-2005
- Last Update Date
- 07-29-2022
- Code Navigator
According to the Nursing Home Compare program data, Evergreen Retirement Community, Inc. has a much above average overall quality rating based on the provider's performance on three separate measures including: health inspections, staffing, and quality of resident care information. These quality measures, combined in a star rating of 5 out of 5 stars provide a snapshot of this nursing home quality.
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.
- 2057
- License State
- WI
- 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:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- Prestige Bronze $0 Medical Deductible - HMO
- Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
- Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
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 |
|---|---|---|---|
| 20136400 | MEDICAID (05) | WI |
Nursing Home Quality Information
The Centers for Medicare and Medicaid Services publishes the Nursing Home Compare star rating data to provide consumers an easy way to compare nursing home's quality of care.
| Overall Quality Rating | - 5 out of 5 stars - Much Above Average |
| The overall star rating is based on a nursing homes's performance on health inspections, staffing and quality measures. | |
| Health Inspection Rating | Not Available |
| The health inspection star rating is based on a nursing home’s weighted score from the most recent health inspections. | |
| Quality Measures Rating | - 5 out of 5 stars - Much Above Average |
| The quality measures star rating is based on data from a select set of clinical measures. | |
| Long-Stay Quality Measures Rating | - 5 out of 5 stars - Much Above Average |
| The long-stay quality of care rating is based on the quality of care delivered to long-term residents only. | |
| Short-Stay Quality Measures Rating | - 4 out of 5 stars - Above Average |
| The short-stay quality of care rating is based on the quality of care delivered to temporary residents only. | |
| Staffing Rating | - 5 out of 5 stars - Much Above Average |
| The staffing rating is based on the star rating based on the nursing home’s staffing hours for Registered Nurses (RNs), Licensed Practice Nurses (LPNs), Licensed Vocational Nurses (LVNs) and Nurse aides. | |
| Nurse Aide Staffing Hours | 3.43 hours per resident per day |
| Nurse aide hours per resident per day. Higher number of hours are better. | |
| RN Staffing Hours | 1.34 hours per resident per day |
| Resgistered nurse hours per resident per day. Higher number of hours are better. | |
| RN Staff Turnover | 17.6% |
| Resgistered nurse turnover is the percentage of registered nursing staff who stop working at the facility within a given year. | |
| Ownership Type | Non profit - Corporation |
| Is the facility private for profit, not-for profit or publicly owned. | |
| Number of Certified Beds | 80 beds |
| Number of beds in the nursing home that have been approved by the federal government to participate in the Medicare or Medicaid programs. | |
| Residents per Day | 56 residents |
| Average number of residents living in the facility per day. | |
| Automatic Sprinkler Systems | Yes |
| Does the facility have automatic sprinkler systems in all required areas? | |
| Facility Reported Incidents | 0 incidents |
| Number of facility-reported incidents in the past 3 years. A lower number is better. | |
| Substantiated Complaints | 0 complaints |
| Number of substantiated complaints in the past 3 years. A lower number is better. | |
| Citations from Inspections | citations after infection control inspection |
| Number of citations from infection control inspections in the past 3 years. A lower number is better. | |
| Total Number of Penalties | 1 penalties from a serious health, fire safety or long-term unresolved citation |
| The Medicare program may impose penalties on a facilty when there's serious health or fire safety citations or if the facility fails to correct a citation for a long period of time. | |
| Number of Fines | 1 fines |
| Toal number of fines in the last 3 years. A penalty can be a fine against the facility or denied payments from Medicare. | |
| Amount of Fines | $650.00 |
| Total monetary amount of fine imposed on the facility in the last 3 years. | |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0701379
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- JANE PETERS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evergreen Retirement Community, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1144213281, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144213281, enumerated as an "organization" on August 24, 2005.
The provider is located at 1130 N WESTFIELD ST OSHKOSH, WI 54902 and the phone number is (920) 233-2340.
Skilled Nursing Facility with taxonomy code 314000000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource. Please consult your insurance carrier or call the provider to verify.
