NPIMap

Organization Active NPI

Everside Health, LLC

  • Family Medicine Physician
  • Decatur, IL
National Provider Identifier
1922671569
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EVERSIDE HEALTH, LLC
Practice address
120 N Franklin Street
Suite 1
Decatur, IL 62523
Phone
(866) 808-6005
NPI assigned
Jul 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

120 N Franklin Street
Suite 1
Decatur, IL 62523

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Everside Health LLC200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

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

Locations

130 N Franklin St
Decatur, IL 62523

2707 E William St
Decatur, IL 62521

120 N Franklin St
Ste 1
Decatur, IL 62523

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1922671569",
    "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": "120 N FRANKLIN STREET",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62523",
            "telephone_number": "866-808-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERSIDE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-17",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.