Joel Everett, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0003272 Issued in FL

Practice address

1130 Beville Rd
Daytona Beach, FL 32114-5743

Phone

(386) 253-6051

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178
  NPD (past)
• Memorial Health Systems Inc

  • Surgery Physician
  • Daytona Beach, FL
  • NPI 1922115914
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: joel.everett.1@26755.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2019.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1710195607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-0141",
            "fax_number": "386-226-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BEVILLE RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145743",
            "telephone_number": "386-253-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 W Granada Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321745109",
            "country_code": "US",
            "telephone_number": "386-425-4480",
            "fax_number": "386-425-4481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "JOEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA0003272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP#",
            "identifier": "94854",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1275640997",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Evans, CRNA
• Sara Josephine Evans, PA-C
• Monique Evelyn, LMHC
• Evencare LLC
• Andrew Edward Everett, MD (ANTICIPATED)
• Mary Kathryn Everett, MD
• Evolution Health & Performance LLC
• Exalt Health Rehabilitation Hospital Daytona LLC
• Excellence Health Care at Home, LLC
• Excellence Health Medical Clinics LLC

• All providers in Daytona Beach, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.