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EVERSIDE HEALTH STI-STATEBORO
NPI 1023749009
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Statesboro, GA

Active since June 21, 2022CLIA 11D2263469 · Waiver
27 EAST VINE STREET, STATESBORO, GA 30458(704) 529-6161 Get Directions Write a Review

NPPES record last updated: May 31, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 31, 2023, Aug 15, 2022 (2 updates tracked since 2022).

About Everside Health Sti-stateboro NPPES

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

EVERSIDE HEALTH STI-STATEBORO (NPI 1023749009) is a healthcare organization registered as a preventive medicine/occupational environmental medicine in Statesboro, Georgia and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through June 28, 2028 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1023749009
Entity TypeOrganization
Primary Taxonomy2083P0500X
Legal Business NameEVERSIDE HEALTH STI-STATEBORO
Location Address27 EAST VINE STREETStatesboro, GA 30458-0850
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Phone(704) 529-6161
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateJune 21, 2022
Last NPPES UpdateMay 31, 20232 updates tracked since enumeration
NPPES CertifiedMay 22, 2023
✔ NPI 1023749009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Preventive Medicine/Occupational Environmental MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0500X
Definition
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
27 EAST VINE STREET, Statesboro, GA 30458
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 11D2263469

Everside Health City Of Statesboro · Statesboro, GA
Active · expires Jun 28, 2028
CLIA Number11D2263469
Laboratory TypeChronic Disease Mgt
Certificate Effective DateJune 29, 2026
Certificate Expiration DateJune 28, 2028
Laboratory DirectorRobert E. Hart
Laboratory Phone(704) 529-6161
Laboratory LocationEverside Health City Of Statesboro27 East Vine Street, Statesboro, GA 30458
CLIA data matches this NPI record on: Address Phone
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 Everside Health Sti-Stateboro's NPI number?

The NPI number for Everside Health Sti-Stateboro is 1023749009. It was assigned to this organization in the NPPES registry on June 21, 2022.

Where is Everside Health Sti-Stateboro located?

Everside Health Sti-Stateboro is located at 27 East Vine Street, Statesboro, GA 30458. The listed phone number is (704) 529-6161.

What is Everside Health Sti-Stateboro's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

Does Everside Health Sti-Stateboro hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2263469) is associated with this NPI, valid through June 28, 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 Everside Health Sti-Stateboro was last updated on May 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.