Active NPI
Everside Health LLC Willingboro NJ
- Preventive Medicine/Occupational Environmental Medicine Physician
- Willingboro, NJ
National Provider Identifier
1740938281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- Legal business name
- EVERSIDE HEALTH LLC WILLINGBORO NJ
- Practice address
- 630 Beverly Rancocas Rd
Willingboro, NJ 08046-3736 - Phone
- (704) 936-5546
- NPI assigned
- Mar 14, 2022
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | Primary |
Addresses
Primary practice location
630 Beverly Rancocas Rd
Willingboro, NJ 08046-3736
Mailing address
4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2270637 | Everside Health LLC - Willingboro | Certificate of waiver | Oct 18, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Everside Health LLC
Organizations with this tax ID in the same state 3
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Family Medicine Physician
- Toms River, NJ
- NPI 1952056020
-
- Preventive Medicine/Occupational Environmental Medicine Physician
- Fair Lawn, NJ
- NPI 1386363349
-
- Family Medicine Physician
- Jersey City, NJ
- NPI 1275191629
Locations
630 Beverly Rancocas Rd
Willingboro, NJ 08046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1647216000000",
"number": "1740938281",
"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": "630 BEVERLY RANCOCAS RD",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080463736",
"telephone_number": "704-936-5546"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERSIDE HEALTH LLC WILLINGBORO NJ",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-14",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"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": "2083P0500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willingboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.