Everwell Medical ,LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

EVERWELL MEDICAL ,LLC

Practice address

2464 Old Fort Pkwy
Murfreesboro, TN 37128-4163

Phone

(615) 410-3137

Fax

(615) 410-3427

NPI assigned

Nov 13, 2023

Last updated

Jan 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ko San Chan

Title

Manager

Phone

(615) 609-5763

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Danielle Nessly, FNP

  • Family Nurse Practitioner
  • Chattanooga, TN
  • NPI 1972942902
  Medicare reassignment NPD
• Joshua G Davenport, PA-C

  • Physician Assistant
  • Virginia Beach, VA
  • NPI 1982297180

  TN

  Medicare reassignment NPD
• Joseph R Contarino, MD

  • Emergency Medicine Physician
  • Murfreesboro, TN
  • NPI 1467491043
  Medicare reassignment
• Sidney Moragne, MD

  • Psychiatry Physician
  • Jackson, TN
  • NPI 1710934906
  Medicare reassignment
• Emmett Earl Wilkerson, MD

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1174553200
  Medicare reassignment
• Eric Gregory Fox, MD

  • Family Medicine Physician
  • Winchester, KY
  • NPI 1174565147
  NPD (past)

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1902670870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2464 OLD FORT PKWY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371284163",
            "telephone_number": "615-410-3137",
            "fax_number": "615-410-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2464 OLD FORT PKWY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371284163",
            "telephone_number": "615-410-3137",
            "fax_number": "615-410-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERWELL MEDICAL ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "KO SAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-609-5763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James Blake Everett, DVM
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• Ogonna Eze
• Sylvester Ifeanyi Ezeabasili, M.PHARM

• Substance Use Disorder Rehabilitation Clinic/Center in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.