EVERGREENHEALTH AND REHAB
NPI 1689840050
Skilled Nursing Facility in Bremerton, WA

NPI Status: Active since May 05, 2008

Contact Information

3517 11TH ST
BREMERTON, WA
ZIP 98312
Phone: (360) 475-0745

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 50D2266435
  • CLIA Cert. Type: Other - AFH
  • CLIA Exp. Date: 04-04-2028

About EVERGREENHEALTH AND REHAB

This page provides the complete NPI Profile along with additional information for Evergreenhealth And Rehab, a provider established in Bremerton, Washington operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1689840050 assigned on May 2008. The practitioner's primary taxonomy code is 314000000X with license number OC00001206 (WA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Mr. Thomas Gerard Kulfan Cota (Certified Occupational Therapy Assi)

NPI
1689840050
Provider Name
EVERGREENHEALTH AND REHAB
Entity Type
Organization
Location Address
3517 11TH ST BREMERTON, WA 98312
Location Phone
(360) 475-0745
Mailing Address
7680 VINEYARDS LN NE APT K302 BREMERTON, WA 98311
Mailing Phone
(360) 689-5673
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-05-2008
Last Update Date
05-05-2008
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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.
OC00001206
License State
WA
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. THOMAS GERARD KULFAN COTA

Authorized Official Title
CERTIFIED OCCUPATIONAL THERAPY ASSI
Authorized Official Phone
(360) 689-5673

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
50D2266435
Facility Type
Other - AFH
Certificate Effective Date
August 29, 2024
Certificate Expiration Date
April 04, 2028
Laboratory Director
MARILYN BAY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Evergreenhealth And Rehab 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 1689840050, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
9
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
4
Unchanged
Pos 7
0
Doubled → 0
Pos 8
0
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
0
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 8 → 16 → 7 8 → 16 → 7 0 → 0 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 6 + 9 + 1 + 6 + 4 + 0 + 0 + 1 + 0 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1689840050.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Skilled Nursing Facility
3517 11TH ST
BREMERTON, WA 98312
Occupational Therapist (Gerontology)
3517 11TH ST
BREMERTON, WA 98312

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689840050, enumerated as an "organization" on May 05, 2008.

The provider is located at 3517 11TH ST BREMERTON, WA 98312 and the phone number is (360) 475-0745.

Skilled Nursing Facility with taxonomy code 314000000X.