NPIMap

Organization Active NPI

Everside Health, LLC

Doing business as Activate Healthcare - Local 357 (Red)

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1467976969
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EVERSIDE HEALTH, LLC
Doing business as
Activate Healthcare - Local 357 (Red)
Practice address
51 N Pecos Rd Ste 110
Las Vegas, NV 89101-4819
Phone
(702) 437-0227
Fax
(702) 437-0228
NPI assigned
Jul 27, 2017
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

51 N Pecos Rd Ste 110
Las Vegas, NV 89101-4819

Mailing address

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

Other names 1

  • Activate Healthcare - Local 357 (Red) Doing business as

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
29D2134653Activate Healthcare-Ibew Local 357 Clinic51 N Pecos Rd Ste 110, Las Vegas, NV 89101Certificate of waiverAug 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Everside Health LLC200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1467976969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N PECOS RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891014819",
            "telephone_number": "702-437-0227",
            "fax_number": "702-437-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "704-936-5546"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Activate Healthcare - Local 357 (Red)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Activate Healthcare - Local 357 (Red)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.