NPIMap

Everside Health, LLC

Organization Active NPI Family Medicine Physician · Nappanee, IN

NPI 1659948271 · NPPES record last updated Aug 11, 2022

Key facts

NPI
1659948271
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
EVERSIDE HEALTH, LLC
Practice address
1405 E Market St
Nappanee, IN 46550-2303
Phone
(866) 808-6005
NPI assigned
Jun 10, 2021
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2227944Everside Health - Nappanee
1405 E Market Street, Nappanee, IN 46550		Certificate of waiverJun 17, 2027

National Provider Directory

Tax ID family
Everside Health LLC (200 organizations share this tax ID)

Locations

1405 E Market St
Nappanee, IN 46550
Phone (574) 544-5423

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

1405 E Market St
Nappanee, IN 46550-2303

Mailing address

1400 Wewatta St Ste 350
Denver, CO 80202-5553

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 11, 2022.

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1659948271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WEWATTA ST STE 350",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802025553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 E MARKET ST",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465502303",
            "telephone_number": "866-808-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nappanee, IN

All providers in Nappanee, IN · Family Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.