1. Home
  2. Directory
  3. Wisconsin
  4. Oconomowoc
  5. Family Medicine
  6. NPI Profile

EVERSIDE HEALTH, LLC
NPI 1033676390
Family Medicine in Oconomowoc, WI

Active since February 22, 2019CLIA 52D2149235 · Waiver
966 BLUE RIBBON CIR N, OCONOMOWOC, WI 53066(262) 977-7211(262) 567-7435 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 28, 2022, Sep 13, 2021, Oct 4, 2019 and 1 more (4 updates tracked since 2019).

About Everside Health, Llc NPPES

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

EVERSIDE HEALTH, LLC (NPI 1033676390) is a healthcare organization registered as a family medicine in Oconomowoc, Wisconsin and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through May 28, 2028 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1033676390
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEVERSIDE HEALTH, LLC
Location Address966 BLUE RIBBON CIR NOconomowoc, WI 53066-8666
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Phone(262) 977-7211
Fax(262) 567-7435
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateFebruary 22, 2019
Last NPPES UpdateJuly 28, 20224 updates tracked since enumeration
NPPES CertifiedJuly 28, 2022
✔ NPI 1033676390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
966 BLUE RIBBON CIR N, Oconomowoc, WI 53066
Open in Google Maps ↗

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 52D2149235

Everside Health, Llc-Oconomowoc Sentry Equipment · Oconomowoc, WI
Active · expires May 28, 2028
CLIA Number52D2149235
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2026
Certificate Expiration DateMay 28, 2028
Laboratory DirectorDr. Jodi Ritter
Laboratory Phone(262) 422-7221
Laboratory LocationEverside Health, Llc-Oconomowoc Sentry Equipment966 Blue Ribbon Circle N, Oconomowoc, WI 53066
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 Everside Health, LLC's NPI number?

The NPI number for Everside Health, LLC is 1033676390. It was assigned to this organization in the NPPES registry on February 22, 2019.

Where is Everside Health, LLC located?

Everside Health, LLC is located at 966 Blue Ribbon Cir N, Oconomowoc, WI 53066. The listed phone number is (262) 977-7211.

What is Everside Health, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Everside Health, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2149235) is associated with this NPI, valid through May 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, LLC was last updated on July 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.