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EVERNORTH DIRECT HEALTH LLC
NPI 1063063089
Clinic/Center in Fort Myers, FL

Active since September 20, 2019CLIA 10D2031194 · Waiver
14311 METROPOLIS AVE STE 102, FORT MYERS, FL 33912(239) 768-0127(239) 768-0671 Get Directions Write a Review

NPPES record last updated: May 3, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 3, 2021, Sep 20, 2019 (2 updates tracked since 2019).

About Evernorth Direct Health Llc NPPES

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

EVERNORTH DIRECT HEALTH LLC (NPI 1063063089) is a healthcare organization registered as a clinic/center in Fort Myers, Florida and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through October 13, 2027 and lists Deborah Sue Coolidge, Financial Analysis Senior Manager, as its authorized official.

NPPES Registry Identity

NPI1063063089
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameEVERNORTH DIRECT HEALTH LLC
Location Address14311 METROPOLIS AVE STE 102Fort Myers, FL 33912-4442
Mailing Address25600 N Norterra DrPhoenix, AZ 85085-8201 · (623) 277-1190
Phone(239) 768-0127
Fax(239) 768-0671
Organization SubpartYes
Authorized OfficialDeborah Sue CoolidgeFinancial Analysis Senior Manager · (623) 277-1170
Enumeration DateSeptember 20, 2019
Last NPPES UpdateMay 3, 20212 updates tracked since enumeration
NPPES CertifiedMay 3, 2021
✔ NPI 1063063089 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).
14311 METROPOLIS AVE STE 102, Fort Myers, FL 33912
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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 10D2031194

Evernorth Direct Health, LLC · Fort Myers, FL
Active · expires Oct 13, 2027
CLIA Number10D2031194
Laboratory TypeOutpatient
Certificate Effective DateOctober 14, 2025
Certificate Expiration DateOctober 13, 2027
Laboratory DirectorDanielle Faulkner
Laboratory Phone(480) 868-0646
Laboratory LocationEvernorth Direct Health, LLC14311 Metropolis Ave - Ste 102, Fort Myers, FL 33912
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHAYNA SMALLWOOD M.D.
Family Medicine
14311 METROPOLIS AVE STE 102
FORT MYERS, FL 33912
Lee County (239) 768-0127

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 1063063089. It was assigned to this organization in the NPPES registry on September 20, 2019.

Where is Evernorth Direct Health LLC located?

Evernorth Direct Health LLC is located at 14311 Metropolis Ave Ste 102, Fort Myers, FL 33912. The listed phone number is (239) 768-0127.

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 10D2031194) is associated with this NPI, valid through October 13, 2027. 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 3, 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.