Galen Mark Eversole, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

12724 Issued in NV

Practice address

301 N Pecos Rd
Suite E
Henderson, NV 89074-1349

Phone

(702) 675-7100

Fax

(702) 675-7101

NPI assigned

Aug 13, 2007

Last updated

Jul 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1508058678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N PECOS RD",
            "address_2": "SUITE E",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741349",
            "telephone_number": "702-675-7100",
            "fax_number": "702-675-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PECOS RD",
            "address_2": "SUITE E",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741349",
            "telephone_number": "702-675-7100",
            "fax_number": "702-675-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSOLE",
        "first_name": "GALEN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "38786",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "83-190",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NV",
            "license": "12724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Everside Health Local 14 Henderson Dispensing
• Everside Health, LLC
• Everside Health, LLC (Teamsters Local 14 with Marathon Health Family Wellness Center - Henderson)
• Everside Health, LLC
• Ellen Eversole, FNP
• Every's Elite Home Care LLC
• Evolved Worldwide, LLC
• Emily Marie Ewing
• Yolanda Marcell Ewing
• Excellence Home Care Solutions

• Anatomic Pathology & Clinical Pathology Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.