Active NPI
Everside Health, LLC
- Primary Care Clinic/Center
- Seymour, IN
National Provider Identifier
1871991976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- EVERSIDE HEALTH, LLC
- Practice address
- 1414 E Tipton St
Seymour, IN 47274-3533 - Phone
- (812) 405-2039
- Fax
- (812) 405-2059
- NPI assigned
- Dec 5, 2014
- Last updated
- Aug 12, 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 |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
1414 E Tipton St
Seymour, IN 47274-3533
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 |
|---|---|---|---|
| 15D2089764 | Everside Health LLC-Aisin Seymour | Certificate of waiver | Jan 7, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Everside Health LLC
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This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660262400000",
"number": "1871991976",
"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": "1414 E TIPTON ST",
"city": "SEYMOUR",
"state": "IN",
"postal_code": "472743533",
"telephone_number": "812-405-2039",
"fax_number": "812-405-2059"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERSIDE HEALTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-12-05",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"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": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seymour, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.