EVERGREEN NURSING & REHABILITATION CARE CENTER
NPI 1245237965
Skilled Nursing Facility in Modesto, CA

Active since July 07, 2005
2030 EVERGREEN AVE, MODESTO, CA 95350(209) 577-1055(209) 550-3619 Get Directions Write a Review

NPPES record last updated: May 21, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreen Nursing & Rehabilitation Care Center NPPES

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

EVERGREEN NURSING & REHABILITATION CARE CENTER (NPI 1245237965) is a healthcare organization registered as a skilled nursing facility in Modesto, California and active in the NPI registry since July 2005. The organization lists Benedict V. Cipponeri, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1245237965
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameEVERGREEN CONVALESCENT HOSPITAL AND REHABILITATION CENTER, INC.
Location Address2030 EVERGREEN AVEModesto, CA 95350-3785
Mailing Address2030 Evergreen AveModesto, CA 95350-3785 · (209) 577-1055 · Fax (209) 550-3619
Fax(209) 550-3619
Organization SubpartNo
Authorized OfficialBenedict V. CipponeriChief Executive Officer · (209) 577-1055
Enumeration DateJuly 7, 2005
Last NPPES UpdateMay 21, 2013
NPI 1245237965 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 CA · 100000038
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.
2030 EVERGREEN AVE, Modesto, CA 95350

Other Names 1

Doing Business AsEvergreen Nursing & Rehabilitation Care Center

Other Identifiers 4

Other13676588CA · State-comp
Medicare OSCAR/certification555118CA
MedicaidZZR55118FCA
Medicare NSC0390550001CA

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
2030 EVERGREEN AVE
MODESTO, CA 95350
Skilled Nursing Facility
2030 EVERGREEN AVE
MODESTO, CA 95350
Occupational Therapy Assistant
2030 EVERGREEN AVE
MODESTO, CA 95350
Occupational Therapy Assistant
2030 EVERGREEN AVE
MODESTO, CA 95350

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 Convalescent Hospital And Rehabilitation Center, Inc.'s NPI number?

The NPI number for Evergreen Convalescent Hospital And Rehabilitation Center, Inc. is 1245237965. It was assigned to this organization in the NPPES registry on July 7, 2005. The provider is doing business as Evergreen Nursing & Rehabilitation Care Center.

Where is Evergreen Convalescent Hospital And Rehabilitation Center, Inc. located?

Evergreen Convalescent Hospital And Rehabilitation Center, Inc. is located at 2030 Evergreen Ave, Modesto, CA 95350. The listed phone number is (209) 577-1055.

What is Evergreen Convalescent Hospital And Rehabilitation Center, Inc.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Evergreen Convalescent Hospital And Rehabilitation Center, Inc. was last updated on May 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.