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JOHNSTON WELLNESS CENTER
NPI 1013401124
Clinic/Center in Johnston, RI

Active since June 21, 2018CLIA 41D2151307 · Waiver
735 GREENVILLE AVE, BLDG D, JOHNSTON, RI 02919(623) 277-1170 Get Directions Write a Review

NPPES record last updated: May 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 14, 2021, May 3, 2021, Jun 21, 2018 (3 updates tracked since 2018).

About Johnston Wellness Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNSTON WELLNESS CENTER (NPI 1013401124) is a healthcare organization registered as a clinic/center in Johnston, Rhode Island and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through July 16, 2028 and lists Deborah Sue Coolidge, Financial Analysis Manager, as its authorized official.

NPPES Registry Identity

NPI1013401124
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameEVERNORTH DIRECT HEALTH LLC
Location Address735 GREENVILLE AVE, BLDG DJohnston, RI 02919
Mailing Address25500 N Norterra DrPhoenix, AZ 85085-8200 · (623) 277-1170
Phone(623) 277-1170
Organization SubpartNo
Authorized OfficialDeborah Sue CoolidgeFinancial Analysis Manager · (623) 277-1170
Enumeration DateJune 21, 2018
Last NPPES UpdateMay 14, 20213 updates tracked since enumeration
NPPES CertifiedMay 14, 2021
✔ NPI 1013401124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
735 GREENVILLE AVE, Johnston, RI 02919
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Other Names 1

Other NameJohnston Wellness Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 41D2151307

Johnston Wellness Center · Johnston, RI
Active · expires Jul 16, 2028
CLIA Number41D2151307
Laboratory TypeOut Patient
Certificate Effective DateJuly 17, 2026
Certificate Expiration DateJuly 16, 2028
Laboratory DirectorMichael Mcgee
Laboratory Phone(480) 868-0646
Laboratory LocationJohnston Wellness Center1 Citizens Bank Way, Johnston, RI 02919
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evernorth Direct Health LLC's NPI number?

The NPI number for Evernorth Direct Health LLC is 1013401124. It was assigned to this organization in the NPPES registry on June 21, 2018. The provider is also known as Johnston Wellness Center.

Where is Evernorth Direct Health LLC located?

Evernorth Direct Health LLC is located at 735 Greenville Ave Bldg D, Johnston, RI 02919. The listed phone number is (623) 277-1170.

What is Evernorth Direct Health LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Evernorth Direct Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D2151307) is associated with this NPI, valid through July 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evernorth Direct Health LLC was last updated on May 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.