Evergreen Clinic LLC
NPI 1689210551ActiveOrganization· Family Medicine· West Jordan, UT
Family Medicine in West Jordan, Utah, registered in NPPES in November 2019. The authorized official on file is Ignacio Nicolas Gonzalez, Administrator.
Overview
| NPI | 1689210551 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 25, 2019 |
| Last updated in NPPES | Jan 13, 2020 |
| Certified by provider | Jan 13, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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 |
|---|
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