NPIMap

Organization Active NPI

Everside Health LLC

Doing business as Teamsters Local 14 Red

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1790441822
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EVERSIDE HEALTH LLC
Doing business as
Teamsters Local 14 Red
Practice address
2831 Business Park CT
Las Vegas, NV 89128-9007
Phone
(702) 844-8143
NPI assigned
Nov 12, 2021
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2831 Business Park CT
Las Vegas, NV 89128-9007

Mailing address

4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916

Other names 1

  • Teamsters Local 14 Red Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Everside Health Sacramento200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1790441822",
    "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": "2831 BUSINESS PARK CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289007",
            "telephone_number": "702-844-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "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": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teamsters Local 14 Red",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Teamsters Local 14 Red",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.