NPIMap

Organization Active NPI

Eventus Wholehealth Aco LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Concord, NC
National Provider Identifier
1023796307
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
EVENTUS WHOLEHEALTH ACO LLC
Practice address
101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone
(855) 743-2247
Fax
(855) 857-7333
NPI assigned
Jul 7, 2023
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
George Hall, MDNPI 1518149277
Title
Owner
Phone
(855) 743-2247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781

Mailing address

PO Box 5779
Carol Stream, IL 60197-5779
Phone (855) 743-2247

Other practice location 1

2 Office Park Ct Ste 103
Columbia, SC 29223-5948
Phone (855) 743-2247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230727003681 NC Part B Supplier - Clinic/Group Practice 8921469651 Receives reassigned benefits from 191 practitioners
Practice locations: Raleigh, NC
O20250107002223 SC Part B Supplier - Clinic/Group Practice 8921469651 Receives reassigned benefits from 6 practitioners
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 194

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 194

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1023796307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5779",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601975779",
            "telephone_number": "855-743-2247",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253781",
            "telephone_number": "855-743-2247",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Office Park Ct Ste 103",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292235948",
            "country_code": "US",
            "telephone_number": "855-743-2247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVENTUS WHOLEHEALTH ACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-07",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-743-2247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.