NPIMap

Organization Active NPI

Everside Health, LLC

Doing business as Activate Healthcare - Waste Away Group

  • Clinic/Center
  • Elkhart, IN
National Provider Identifier
1093360059
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVERSIDE HEALTH, LLC
Doing business as
Activate Healthcare - Waste Away Group
Practice address
1621 W Beardsley Ave
Elkhart, IN 46514-1825
Phone
(773) 697-3144
NPI assigned
Aug 7, 2019
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1621 W Beardsley Ave
Elkhart, IN 46514-1825

Mailing address

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

Other names 1

  • Activate Healthcare - Waste Away Group Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2176038Everside Health-Waste Away Group1621 W Beardsley Avenue, Elkhart, IN 46514Certificate of waiverDec 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Everside Health LLC200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

3270 Intertech Dr
Angola, IN 46703
Phone (260) 305-2622

1001 Parkway Ave
Ste 11
Elkhart, IN 46516
Phone (574) 206-4399

1405 E Market St
Nappanee, IN 46550
Phone (574) 544-5423

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1093360059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 W BEARDSLEY AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141825",
            "telephone_number": "773-697-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-07",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "704-936-5546"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Activate Healthcare - Waste Away Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Activate Healthcare - Waste Away Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.