Organization Active NPI

Evernorth Direct Health LLC

  • Clinic/Center
  • Calhoun, GA
National Provider Identifier
1942911763
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVERNORTH DIRECT HEALTH LLC
Practice address
196 S Industrial Blvd
Calhoun, GA 30701-3030
Phone
(706) 422-2550
Fax
(706) 422-2560
NPI assigned
Dec 13, 2022
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
EVERNORTH DIRECT HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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 Senior Manager
Phone
(623) 277-1170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

196 S Industrial Blvd
Calhoun, GA 30701-3030

Mailing address

25600 N Norterra Dr
Phoenix, AZ 85085-8201

Other names 1

  • Mohawk HLC Calhoun Other name

National Provider Directory

National Provider Directory
Tax ID family
Evernorth Direct Health LLC104 organizations share this tax ID, including this one
Part of
Evernorth Direct Health LLC

Organizations with this tax ID in the same state 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1942911763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25600 N NORTERRA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 S INDUSTRIAL BLVD",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013030",
            "telephone_number": "706-422-2550",
            "fax_number": "706-422-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH LLC",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "FINANCIAL ANALYSIS SENIOR 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": "Mohawk HLC Calhoun",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.