Evergreen Physical Medicine, LLC
NPI 1538668421 · Family Nurse Practitioner · Meridian, ID
Evergreen Physical Medicine, LLC is a Family Nurse Practitioner organization in Meridian, ID (NPI 1538668421).
Provider details
- NPI number
- 1538668421
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Summer Dance, Executive Director(208) 895-8595
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Evergreen Physical Medicine
Registry dates
- Enumerated
- 2018-02-06
- Last updated
- 2018-02-06
Frequently asked questions
- What is Evergreen Physical Medicine, LLC's NPI number?
- Evergreen Physical Medicine, LLC's National Provider Identifier (NPI) is 1538668421, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evergreen Physical Medicine, LLC?
- Evergreen Physical Medicine, LLC is classified in the NPPES registry as Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Evergreen Physical Medicine, LLC located?
- Evergreen Physical Medicine, LLC's practice location on file with NPPES is 1710 W Cherry Ln, Meridian, ID 83642-1340.
- What is Evergreen Physical Medicine, LLC's phone number?
- The practice phone number listed in the NPPES registry for Evergreen Physical Medicine, LLC is (208) 895-8595.
- Who is the authorized official for Evergreen Physical Medicine, LLC?
- The authorized official listed on Evergreen Physical Medicine, LLC's NPPES record is Summer Dance, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evergreen Physical Medicine, LLC's NPI active?
- Yes — Evergreen Physical Medicine, LLC's NPI (1538668421) is active in the NPPES registry as of the last update on 2018-02-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.