NPIMap

Everside Health, LLC

Organization Active NPI Primary Care Clinic/Center · Mishawaka, IN

NPI 1316320443 · NPPES record last updated Jul 28, 2022

Key facts

NPI
1316320443
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
EVERSIDE HEALTH, LLC
Practice address
333 E Mishawaka Ave
Mishawaka, IN 46545-6600
Phone
(574) 314-5950
Fax
(574) 314-5949
NPI assigned
Jul 7, 2015
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 23

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

Practitioners 5

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2125639Everside Health, LLC City of Mishawaka
333 East Mishawaka Avenue, Mishawaka, IN 46545		Certificate of waiverFeb 9, 2027

National Provider Directory

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

Locations

1621 W Beardsley Ave
Elkhart, IN 46514
Phone (574) 206-4156

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

333 E Mishawaka Ave
Mishawaka, IN 46545-6600

Mailing address

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

Other providers in Mishawaka, IN

All providers in Mishawaka, IN · Primary Care Clinic/Center in Indiana

Sources for this page

Verify at the official NPI Registry.