Evernorth Direct Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVERNORTH DIRECT HEALTH LLC

Practice address

600 Highway 32
Water Valley, MS 38965-6431

Phone

(662) 473-5728

Fax

(662) 473-5755

NPI assigned

Feb 2, 2022

Last updated

Feb 2, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

EVERNORTH DIRECT HEALTH LLCAs reported in NPPES

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

Addresses

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 1

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

• Evernorth Direct Health LLC

  • Clinic/Center
  • Water Valley, MS
  • NPI 1508441866
  NPD tax ID

Locations

Practitioners 1

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.

• Ashley Marie Griffith, CFNP

  • Family Nurse Practitioner
  • Water Valley, MS
  • NPI 1295822823
  NPD (past)

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1558014100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25600 N NORTERRA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858201",
            "telephone_number": "480-589-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHWAY 32",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389656431",
            "telephone_number": "662-473-5728",
            "fax_number": "662-473-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH LLC",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-01-24",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matt Defrancisco, DPT
• Hunter Edwards, OD
• Stephen Patrick Edwards, O. D.
• Taylor Watkins Edwards, OD
• Evernorth Direct Health LLC
• Family Health Care Clinic, Inc.
• Family Practice Clinic of Water Valley
• Family Practice Clinic of Water Valley
• Taylor Robertson Faulkner, DPT
• Cody Elizabeth Field, FNP-C

• Clinic/Center in Water Valley, MS
• Providers in Water Valley, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.