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Everside Health Thomas and Skinnder Health Center

Organization Active NPI Preventive Medicine/Occupational Environmental Medicine Physician · Indianapolis, IN

NPI 1073212932 · NPPES record last updated Mar 1, 2023

Key facts

NPI
1073212932
Entity type
Organization (NPI type 2)
Primary specialty
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X
Legal business name
EVERSIDE HEALTH THOMAS AND SKINNDER HEALTH CENTER
Practice address
1120 E 23Rd St
Indianapolis, IN 46205-4508
Phone
(704) 661-1380
NPI assigned
Mar 1, 2023
Organization subpart
No

Authorized official

Name
Jill Johnson Patton
Title
Director of Risk Management
Phone
(704) 936-5546

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2278205Everside Health Thomas & Skinner Health Center
1120 East 23Rd Street, Indianapolis, IN 46205		Certificate of waiverMar 13, 2027

National Provider Directory

Tax ID family
Everside Health LLC (200 organizations share this tax ID)

Locations

1120 E 23rd St
Indianapolis, IN 46205

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2083P0500X Yes

Addresses

Primary practice location

1120 E 23Rd St
Indianapolis, IN 46205-4508

Mailing address

4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Preventive Medicine/Occupational Environmental Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.