EVERSIDE HEALTH-ANTIOCH
NPI 1104604693
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Antioch, CA
NPI Status: Active since September 18, 2023
Contact Information
5201 DEER VALLEY RD STE 1E
ANTIOCH, CA
ZIP 94531
Phone: (704) 661-1380
- Organization
- Preventive Medicine
- Preventive Medicine/Occupational Environ...
- CLIA Number: 05D2296307
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-26-2027
About EVERSIDE HEALTH-ANTIOCH
This page provides the complete NPI Profile along with additional information for Everside Health-antioch, a provider established in Antioch, California operating as a Preventive Medicine, focusing in preventive medicine/occupational environmental medicine . The healthcare provider is registered in the NPI registry with number 1104604693 assigned on September 2023. The practitioner's primary taxonomy code is 2083P0500X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jill Johnson Patton (Director Of Risk Management)
- NPI
- 1104604693
- Provider Name
- EVERSIDE HEALTH-ANTIOCH
- Entity Type
- Organization
- Location Address
- 5201 DEER VALLEY RD STE 1E ANTIOCH, CA 94531
- Location Phone
- (704) 661-1380
- Mailing Address
- 4651 CHARLOTTE PARK DR STE 300 CHARLOTTE, NC 28217
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-18-2023
- Last Update Date
- 09-18-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Preventive Medicine Preventive Medicine/Occupational Environmental Medicine
- Taxonomy Code
- 2083P0500X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2296307
- Facility Type
- Physician Office
- Certificate Effective Date
- December 27, 2025
- Certificate Expiration Date
- December 26, 2027
- Laboratory Director
- JOHN LANDSBERG
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Everside Health-antioch to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104604693, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
ANTIOCH, CA 94531
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104604693, enumerated as an "organization" on September 18, 2023.
The provider is located at 5201 DEER VALLEY RD STE 1E ANTIOCH, CA 94531 and the phone number is (704) 661-1380.
Preventive Medicine with taxonomy code 2083P0500X and a focus in Preventive Medicine/Occupational Environmental Medicine.
