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ACTIVATE HEALTHCARE - WASTE AWAY GROUP
NPI 1093360059
Clinic/Center - Primary Care in Elkhart, IN

Active since August 07, 2019CLIA Certified · 4 labs
1621 W BEARDSLEY AVE, ELKHART, IN 46514(773) 697-3144 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2022, Sep 9, 2021, Sep 23, 2019 and 1 more (4 updates tracked since 2019).

About Activate Healthcare - Waste Away Group NPPES

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

ACTIVATE HEALTHCARE - WASTE AWAY GROUP (NPI 1093360059) is a healthcare organization registered as a primary care in Elkhart, Indiana and active in the NPI registry since August 2019. The organization holds 4 active CLIA laboratory certificates and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1093360059
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEVERSIDE HEALTH, LLC
Location Address1621 W BEARDSLEY AVEElkhart, IN 46514-1825
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Phone(773) 697-3144
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateAugust 7, 2019
Last NPPES UpdateJuly 28, 20224 updates tracked since enumeration
NPPES CertifiedJuly 28, 2022
✔ NPI 1093360059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1621 W BEARDSLEY AVE, Elkhart, IN 46514
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Other Names 1

Doing Business AsActivate Healthcare - Waste Away Group

CLIA Laboratory Certificates CMS CLIA 4

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 15D2176038

Everside Health-Waste Away Group · Elkhart, IN
Active · expires Dec 5, 2027
CLIA Number15D2176038
Laboratory TypePhysician Office
Certificate Effective DateDecember 6, 2025
Certificate Expiration DateDecember 5, 2027
Laboratory DirectorPatricia Jordan
Laboratory Phone(574) 206-4156
Laboratory LocationEverside Health-Waste Away Group1621 W Beardsley Avenue, Elkhart, IN 46514
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2180212

Everside Health, LLC City Of Kalamazoo · Kalamazoo, MI
Active · expires Mar 9, 2028
CLIA Number23D2180212
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2026
Certificate Expiration DateMarch 9, 2028
Laboratory DirectorChristine M. Bourgeois
Laboratory Phone(773) 697-3144
Laboratory LocationEverside Health, LLC City Of Kalamazoo1631 S Westnedge Avenue, Kalamazoo, MI 49008
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2179172

Everside Health, LLC Novi Michigan · Novi, MI
Active · expires Feb 17, 2028
CLIA Number23D2179172
Laboratory TypePhysician Office
Certificate Effective DateFebruary 18, 2026
Certificate Expiration DateFebruary 17, 2028
Laboratory DirectorMichelle Pad
Laboratory Phone(773) 697-3144
Laboratory LocationEverside Health, LLC Novi Michigan39595 W 10 Mile Suite 101, Novi, MI 48375
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 18D2136780

Everside Health, LLC - Local 392 Clinic · Erlanger, KY
Active · expires Sep 14, 2027
CLIA Number18D2136780
Laboratory TypePhysician Office
Certificate Effective DateSeptember 15, 2025
Certificate Expiration DateSeptember 14, 2027
Laboratory DirectorMs. Tracy Mahaney
Laboratory Phone(773) 697-3144
Laboratory LocationEverside Health, LLC - Local 392 Clinic600 Rodeo Drive, Ste 300, Erlanger, KY 41018
CLIA data matches this NPI record on: Name Phone
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.

MRS. DEBORAH CAROL NETHERCUTT NP-C
Nurse Practitioner (Family)
1621 W BEARDSLEY AVE
ELKHART, IN 46514
Elkhart County (574) 206-4156

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 1093360059. It was assigned to this organization in the NPPES registry on August 7, 2019. The provider is doing business as Activate Healthcare - Waste Away Group.

Where is Everside Health, LLC located?

Everside Health, LLC is located at 1621 W Beardsley Ave, Elkhart, IN 46514. The listed phone number is (773) 697-3144.

What is Everside Health, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Everside Health, LLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

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.