Everist Genomics, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

23D20178 Issued in MI

Legal business name

EVERIST GENOMICS, INC.

Practice address

709 W Ellsworth Rd
Ann Arbor, MI 48108-3371

Phone

(734) 929-6302

Fax

(734) 929-9501

NPI assigned

Nov 4, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Vicki Theisen

Title

General Manager

Phone

(734) 929-6305

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1750668703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W ELLSWORTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083371",
            "telephone_number": "734-929-6302",
            "fax_number": "734-929-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W ELLSWORTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083371",
            "telephone_number": "734-929-6302",
            "fax_number": "734-929-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERIST GENOMICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "THEISEN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "734-929-6305",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D20178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lu Andich Evergreen, MSW
• Everist Genomics
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• Kevin C Eves, PA
• Kelsey Evey
• Evolve Psychotherapy Services LLC
• Courtney H Evron, PA-C

• Clinical Medical Laboratory in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.