NPIMap

Organization Active NPI

Evernorth Direct Health LLC

  • Clinic/Center
  • San Antonio, TX
National Provider Identifier
1194247247
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVERNORTH DIRECT HEALTH LLC
Practice address
3302 N Ellison Dr
San Antonio, TX 78251-4773
Phone
(210) 767-4690
Fax
(210) 767-4699
NPI assigned
Jul 11, 2017
Last updated
May 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3302 N Ellison Dr
San Antonio, TX 78251-4773

Mailing address

25500 N Norterra Dr
Phoenix, AZ 85085-8200
Phone (877) 733-1710

Other names 1

  • San Antonio Health & Wellness; Cigna Onsite Health Other name

National Provider Directory

National Provider Directory
Tax ID family
Evernorth Direct Health LLC104 organizations share this tax ID, including this one

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

3302 N Ellison Dr
San Antonio, TX 78251
Phone (210) 767-4690

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1194247247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 N NORTERRA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858200",
            "telephone_number": "877-733-1710",
            "fax_number": "623-277-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 N ELLISON DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514773",
            "telephone_number": "210-767-4690",
            "fax_number": "210-767-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "FINANCIAL ANALYSIS 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": "San Antonio Health & Wellness; Cigna Onsite Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.