Organization Active NPI

Evernorth Care Providers - New Jersey PC

  • General Practice Physician
  • Totowa, NJ
National Provider Identifier
1174874200
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EVERNORTH CARE PROVIDERS - NEW JERSEY PC
Practice address
999 Riverview Dr FL 2
Totowa, NJ 07512-1164
Phone
(773) 292-4800
Fax
(312) 564-4059
NPI assigned
Sep 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Jacqueline D Lakes
Title
Senior Paralegal
Phone
(954) 446-0640

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X NJ
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

999 Riverview Dr FL 2
Totowa, NJ 07512-1164

Mailing address

730 Cool Springs Blvd Ste 500
Franklin, TN 37067-7331
Phone (773) 292-4800

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
31D2164200Evernorth Care Providers-999 Riverview Drive, Totowa, NJ 07512Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory

Locations

115 Tabor Rd
Morris Plains, NJ 07950

103 Carnegie Ctr
Ste 308
Princeton, NJ 08540

103 Carnegie Ctr
#308
Princeton, NJ 08540

999 Riverview Dr
Fl 2
Totowa, NJ 07512
Phone (609) 605-0249

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1174874200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 COOL SPRINGS BLVD STE 500",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677331",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 RIVERVIEW DR FL 2",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121164",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH CARE PROVIDERS - NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "LAKES",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SENIOR PARALEGAL",
        "authorized_official_telephone_number": "954-446-0640"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.