NPIMap

Organization Active NPI

Everside Health, LLC

Doing business as Paladina Health Stoneridge

  • Family Medicine Physician
  • Waukesha, WI
National Provider Identifier
1619423092
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EVERSIDE HEALTH, LLC
Doing business as
Paladina Health Stoneridge
Practice address
N14W23833 Stone Ridge Dr
Suite 450
Waukesha, WI 53188-1157
Phone
(877) 360-4966
Fax
(262) 347-0032
NPI assigned
Aug 26, 2016
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DAVITA HEALTHCARE PARTNERS, INCAs reported in NPPES

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

N14W23833 Stone Ridge Dr
Suite 450
Waukesha, WI 53188-1157

Mailing address

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

Other names 1

  • Paladina Health Stoneridge Doing business as

National Provider Directory

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

Organizations with this tax ID in the same state 9

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

Locations

N14W23833 Stone Ridge Dr
Ste 450
Waukesha, WI 53188
Phone (877) 360-4966

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1619423092",
    "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": "N14W23833 STONE RIDGE DR",
            "address_2": "SUITE 450",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881157",
            "telephone_number": "877-360-4966",
            "fax_number": "262-347-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA HEALTHCARE PARTNERS, INC",
        "enumeration_date": "2016-08-26",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paladina Health Stoneridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paladina Health Stoneridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukesha, WI

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.