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EVERGREEN VILLAGE AT FORT WAYNE
NPI 1194358119
Assisted Living Facility in Fort Wayne, IN

Active since February 18, 2020CLIA 15D2186438 · Waiver
12523 AUBURN RD, FORT WAYNE, IN 46845(260) 637-2830(260) 367-9393 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 18, 2024, Oct 11, 2023, Feb 18, 2020 (3 updates tracked since 2020).

About Evergreen Village At Fort Wayne NPPES

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

EVERGREEN VILLAGE AT FORT WAYNE (NPI 1194358119) is a healthcare organization registered as an assisted living facility in Fort Wayne, Indiana and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through June 16, 2028 and lists Greg Echols, Co-president Of Management Company, as its authorized official.

NPPES Registry Identity

NPI1194358119
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEV FW LIMITED PARTNERSHIP
Location Address12523 AUBURN RDFort Wayne, IN 46845-8797
Mailing Address200 E Court St Ste 400Kankakee, IL 60901-3848 · (815) 935-1992 · Fax (815) 935-8380
Phone(260) 637-2830
Fax(260) 367-9393
Organization SubpartNo
Authorized OfficialGreg EcholsCo-president Of Management Company · (815) 935-1992
Enumeration DateFebruary 18, 2020
Last NPPES UpdateSeptember 18, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2024
✔ NPI 1194358119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
12523 AUBURN RD, Fort Wayne, IN 46845
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Other Names 1

Doing Business AsEvergreen Village At Fort Wayne

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 15D2186438

Ev Fw Limited Partnership · Fort Wayne, IN
Active · expires Jun 16, 2028
CLIA Number15D2186438
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 17, 2026
Certificate Expiration DateJune 16, 2028
Laboratory DirectorChristine Cummins
Laboratory Phone(260) 637-2830
Laboratory LocationEv Fw Limited Partnership12523 Auburn Road, Fort Wayne, IN 46845
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

KAREN LEE FRERKING OTR/L
Occupational Therapist
12523 AUBURN RD
FORT WAYNE, IN 46845
Allen County (260) 637-2830
ARCHANA YENNU PT, DPT
Physical Therapist
12523 AUBURN RD
FORT WAYNE, IN 46845
Allen County (260) 637-2830
MATTHEW RYAN ZACHMAN PTA
Physical Therapy Assistant
12523 AUBURN RD
FORT WAYNE, IN 46845
Allen County (260) 204-0546

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 Ev Fw Limited Partnership's NPI number?

The NPI number for Ev Fw Limited Partnership is 1194358119. It was assigned to this organization in the NPPES registry on February 18, 2020. The provider is doing business as Evergreen Village At Fort Wayne.

Where is Ev Fw Limited Partnership located?

Ev Fw Limited Partnership is located at 12523 Auburn Rd, Fort Wayne, IN 46845. The listed phone number is (260) 637-2830.

What is Ev Fw Limited Partnership's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Ev Fw Limited Partnership hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2186438) is associated with this NPI, valid through June 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ev Fw Limited Partnership was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.