Evergreen Physical Medicine, LLC
NPI 1538668421ActiveOrganization· Nurse Practitioner, Family· Meridian, ID
Nurse Practitioner, Family in Meridian, Idaho, registered in NPPES in February 2018. The authorized official on file is Summer Dance, Executive Director.
Overview
| NPI | 1538668421 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 6, 2018 |
| Last updated in NPPES | Feb 6, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Nurse Practitioner, Family providers in Meridian
- 1801567029
- 1326345661
- 1568093136
- 1295138261
- 1104680602
- 1033424429
- 1952845109
- 1285293118
- 1043868995
- 1194186437
- 1912221318
- 1205435757