NPIMap

Organization Active NPI

Evernorth Direct Health LLC

  • Clinic/Center
  • Dallas, TX
National Provider Identifier
1154049856
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVERNORTH DIRECT HEALTH LLC
Practice address
7834 C F Hawn Fwy
Dallas, TX 75217-6529
Phone
(214) 309-3438
Fax
(214) 309-3431
NPI assigned
Aug 18, 2022
Last updated
Aug 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
EVERNORTH DIRECT HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Deborah Sue Coolidge
Title
Financial Analysis Senior Manager
Phone
(623) 277-1170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

7834 C F Hawn Fwy
Dallas, TX 75217-6529

Mailing address

7834 C F Hawn Fwy
Dallas, TX 75217-6529
Phone (214) 309-3438

Other names 1

  • Mohawk Healthy Life Center Dallas Other name

National Provider Directory

National Provider Directory
Tax ID family
Evernorth Direct Health LLC102 organizations share this tax ID, including this one
Part of
Evernorth Direct Health LLC

Organizations with this tax ID in the same state 8

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

Locations

7834 C F Hawn Fwy
Dallas, TX 75217
Phone (214) 309-3438

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1154049856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7834 C F HAWN FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752176529",
            "telephone_number": "214-309-3438",
            "fax_number": "214-309-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7834 C F HAWN FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752176529",
            "telephone_number": "214-309-3438",
            "fax_number": "214-309-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH LLC",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "FINANCIAL ANALYSIS SENIOR MANAGER",
        "authorized_official_telephone_number": "623-277-1170"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mohawk Healthy Life Center Dallas",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.