Everside Health, LLC

Organization Active NPI Family Medicine Physician · Fowler, IN

NPI 1104599893 · NPPES record last updated Jul 28, 2022

Key facts

NPI
1104599893
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
EVERSIDE HEALTH, LLC
Practice address
604 E 2ND St Ste a
Fowler, IN 47944-1383
Phone
(866) 808-6005
NPI assigned
Jul 28, 2021
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 17

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

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

Locations

926 W 500 S
Berne, IN 46711
Phone (260) 849-4296

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

604 E 2ND St Ste a
Fowler, IN 47944-1383

Mailing address

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

Other providers in Fowler, IN

All providers in Fowler, IN · Family Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.