Evernorth Direct Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVERNORTH DIRECT HEALTH LLC

Practice address

202 Jacobs Ave
Bridgeport, AL 35740-6682

Phone

(256) 495-2928

Fax

(256) 495-2928

NPI assigned

May 12, 2023

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

EVERNORTH DIRECT HEALTH LLCAs reported in NPPES

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

Addresses

Other names 1

• Mohawk HLC Bridgeport Other name

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

CLIA laboratory certificates

Tax ID family

Evernorth Direct Health LLC104 organizations share this tax ID, including this one

Part of

Evernorth Direct Health LLC

Organizations with this tax ID in the same state 3

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

• Evernorth Direct Health LLC

  dba Roanoke Healthy Life Center- Mohawk

  • Non-Pharmacy Dispensing Site
  • Roanoke, AL
  • NPI 1477983278
  NPD tax ID
• Evernorth Direct Health LLC

  • Clinic/Center
  • Roanoke, AL
  • NPI 1790481091
  NPD tax ID
• Evernorth Direct Health LLC

  • Clinic/Center
  • Florence, AL
  • NPI 1942990833
  NPD tax ID

Locations

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1245920131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8888 E RAINTREE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 JACOBS AVE",
            "city": "BRIDGEPORT",
            "state": "AL",
            "postal_code": "357406682",
            "telephone_number": "256-495-2928",
            "fax_number": "256-495-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH LLC",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "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 HLC Bridgeport",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bridgeport Family Practice OBGYN Clinic (Mohan & Mohan Medical East)
• Bridgeport Pain Clinic
• Ashley Nicole Carper
• Paige Cloud, PHARM. D
• Essential Access Healthcare, LLC
• HH Health System - Jackson LLC (Cumberland Health and Rehab)
• Brandi Linette Hicks, R.N., C.R.N.P.
• Jackson County Healthcare Authority (Cumberland Health and Rehab)
• Laxmi LLC (M & M Diagnostics & WalkIn)
• Vinai Montricul, M.D.

• Clinic/Center in Bridgeport, AL
• Providers in Bridgeport, AL by specialty
• Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.