Evernorth Direct Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVERNORTH DIRECT HEALTH LLC

Practice address

1 National Life Dr
Montpelier, VT 05604-1000

Phone

(770) 281-3597

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Deborah Sue Coolidge

Title

Financial Analysis Manager

Phone

(623) 277-1170

Specialties & licenses 1

Addresses

Other names 1

• National Life Group Other name

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

CLIA laboratory certificates

Tax ID family

Evernorth Direct Health LLC102 organizations share this tax ID, including this one

Locations

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1780185991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 N NORTERRA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858200",
            "telephone_number": "877-733-1710",
            "fax_number": "623-277-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NATIONAL LIFE DR",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056041000",
            "telephone_number": "770-281-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "FINANCIAL ANALYSIS MANAGER",
        "authorized_official_telephone_number": "623-277-1170"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "National Life Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinic/Center in Montpelier, VT
• Providers in Montpelier, VT by specialty
• Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.

Verify at the official NPI Registry.