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EVERGREEN CLINIC LLC
NPI 1689210551
Family Medicine in West Jordan, UT

Active since November 25, 2019
1561 W 7000 S STE 100, WEST JORDAN, UT 84084(801) 850-1958(801) 747-6881 Get Directions Write a Review

NPPES record last updated: January 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 13, 2020, Nov 25, 2019 (2 updates tracked since 2019).

About Evergreen Clinic Llc NPPES

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

EVERGREEN CLINIC LLC (NPI 1689210551) is a healthcare organization registered as a family medicine in West Jordan, Utah and active in the NPI registry since November 2019. The organization lists Ignacio Nicolas Gonzalez, Administrator, as its authorized official.

NPPES Registry Identity

NPI1689210551
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEVERGREEN CLINIC LLC
Location Address1561 W 7000 S STE 100West Jordan, UT 84084-3556
Mailing AddressPo Box 9193Midvale, UT 84047-9170 · (801) 850-1958
Phone(801) 850-1958
Fax(801) 747-6881
Organization SubpartNo
Authorized OfficialIgnacio Nicolas GonzalezAdministrator · (801) 850-1958
Enumeration DateNovember 25, 2019
Last NPPES UpdateJanuary 13, 20202 updates tracked since enumeration
✔ NPI 1689210551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1561 W 7000 S STE 100, West Jordan, UT 84084
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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

Other Providers at the Same Location NPPES

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

TREE OF LIFE MEDICAL AND WELLNESS CENTER
Clinic/Center (Multi-Specialty)
1561 W 7000 S STE 100
WEST JORDAN, UT 84084
Salt Lake County (801) 679-1641

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 Clinic LLC's NPI number?

The NPI number for Evergreen Clinic LLC is 1689210551. It was assigned to this organization in the NPPES registry on November 25, 2019.

Where is Evergreen Clinic LLC located?

Evergreen Clinic LLC is located at 1561 W 7000 S Ste 100, West Jordan, UT 84084. The listed phone number is (801) 850-1958.

What is Evergreen Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Evergreen Clinic LLC was last updated on January 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.