NPIMap

Organization Active NPI

Everside Health, LLC

  • Clinic/Center
  • South Bend, IN
National Provider Identifier
1497306310
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVERSIDE HEALTH, LLC
Practice address
3371 W Cleveland Road Ext Ste 120
South Bend, IN 46628-9780
Phone
(574) 218-6700
Fax
(574) 218-6708
NPI assigned
Sep 23, 2019
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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3371 W Cleveland Road Ext Ste 120
South Bend, IN 46628-9780

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Everside Health Sacramento200 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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1497306310",
    "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": "3371 W CLEVELAND ROAD EXT STE 120",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289780",
            "telephone_number": "574-218-6700",
            "fax_number": "574-218-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-23",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.