NPIMap

Organization Active NPI

Evernorth Direct Health LLC

  • Clinic/Center
  • Saint Cloud, FL
National Provider Identifier
1336986256
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVERNORTH DIRECT HEALTH LLC
Practice address
2950 Lakeshore Blvd
Saint Cloud, FL 34769-1946
Phone
(623) 277-1190
NPI assigned
Jul 9, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EVERNORTH DIRECT HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

2950 Lakeshore Blvd
Saint Cloud, FL 34769-1946

Mailing address

8888 E Raintree Dr
Scottsdale, AZ 85260-3951

Other names 1

  • City of St Cloud Health & Wellness Center Other name

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
10D2311114Evernorth Direct Health LLC2950 Lakeshore Blvd, Saint Cloud, FL 34769Certificate of waiverSep 16, 2026

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 12

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

Locations

2950 Lakeshore Blvd
Saint Cloud, FL 34769
Phone (407) 957-7217

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1336986256",
    "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": "2950 LAKESHORE BLVD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691946",
            "telephone_number": "623-277-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH LLC",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "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": "City of St Cloud Health & Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.