EVERGREEN HOME CARR
NPI 1205503117
Clinical Nurse Specialist - Home Health in Cincinnati, OH

Active since August 27, 2021CLIA 36D2234565 · Waiver
2852 BOUDINOT AVE STE 202, CINCINNATI, OH 45238(614) 592-8678 Get Directions Write a Review

NPPES record last updated: May 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 3, 2024, Sep 16, 2021, Aug 27, 2021 (3 updates tracked since 2021).

About Evergreen Home Carr NPPES

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

EVERGREEN HOME CARR (NPI 1205503117) is a healthcare organization registered as a home health in Cincinnati, Ohio and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through April 21, 2028 and lists Omar Y Farah, Ceo, as its authorized official.

NPPES Registry Identity

NPI1205503117
Entity TypeOrganization
Primary Taxonomy364SH0200X
Legal Business NameEVERGREEN HOME CARE
Location Address2852 BOUDINOT AVE STE 202Cincinnati, OH 45238-2461
Mailing Address2852 Boudinot AveCincinnati, OH 45238-2461 · (614) 592-8678
Organization SubpartNo
Authorized OfficialOmar Y FarahCeo · (614) 592-8678
Enumeration DateAugust 27, 2021
Last NPPES UpdateMay 3, 20243 updates tracked since enumeration
NPPES CertifiedMay 3, 2024
NPI 1205503117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Nurse Specialist · Home HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SH0200X
2852 BOUDINOT AVE STE 202, Cincinnati, OH 45238

Other Names 2

Doing Business AsEvergreen Home Carr
Doing Business AsEvergreen Home Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 36D2234565

Evergreen Home Care · Cincinnati, OH
Active · expires Apr 21, 2028
CLIA Number36D2234565
Laboratory TypeHome Health Agency
Certificate Effective DateApril 22, 2026
Certificate Expiration DateApril 21, 2028
Laboratory DirectorOmar Y. Farah
Laboratory Phone(614) 592-8678
Laboratory LocationEvergreen Home Care2852 Boudinot Ave Suite 202, Cincinnati, OH 45238
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Home Health Quality Ratings CMS Care Compare

Quality ratings, patient care measures and outcomes for Evergreen Home Care (CMS certification number 369361), from CMS Care Compare.

Evergreen Home Care

Home health agency · Cincinnati, OH
CMS Certification Number369361
Medicare-Certified SinceJuly 20, 2023

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 Evergreen Home Care's NPI number?

The NPI number for Evergreen Home Care is 1205503117. It was assigned to this organization in the NPPES registry on August 27, 2021. The provider is doing business as Evergreen Home Carr.

Where is Evergreen Home Care located?

Evergreen Home Care is located at 2852 Boudinot Ave Ste 202, Cincinnati, OH 45238. The listed phone number is (614) 592-8678.

What is Evergreen Home Care's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Home Health, with taxonomy code 364SH0200X.

Does Evergreen Home Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2234565) is associated with this NPI, valid through April 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Evergreen Home Care a Medicare-certified home health agency?

Yes. Evergreen Home Care is a Medicare-certified home health agency, certified since July 20, 2023.

When was this NPI record last updated?

The NPPES record for Evergreen Home Care was last updated on May 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.