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EVERNORTH CARE PROVIDERS - NEW JERSEY PC
NPI 1174874200
General Practice in Totowa, NJ

Active since September 28, 2012CLIA 31D2164200 · Waiver
999 RIVERVIEW DR FL 2, TOTOWA, NJ 07512(773) 292-4800(312) 564-4059 Get Directions Write a Review

NPPES record last updated: July 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 13, 2023, Aug 9, 2023, Feb 2, 2022 and 1 more (4 updates tracked since 2017).

About Evernorth Care Providers - New Jersey Pc NPPES

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

EVERNORTH CARE PROVIDERS - NEW JERSEY PC (NPI 1174874200) is a healthcare organization registered as a general practice in Totowa, New Jersey and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through March 28, 2027 and lists Jacqueline D Lakes, Senior Paralegal, as its authorized official.

NPPES Registry Identity

NPI1174874200
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameEVERNORTH CARE PROVIDERS - NEW JERSEY PC
Location Address999 RIVERVIEW DR FL 2Totowa, NJ 07512-1164
Mailing Address730 Cool Springs Blvd Ste 500Franklin, TN 37067-7331 · (773) 292-4800 · Fax (312) 564-4059
Phone(773) 292-4800
Fax(312) 564-4059
Organization SubpartNo
Authorized OfficialJacqueline D LakesSenior Paralegal · (954) 446-0640
Enumeration DateSeptember 28, 2012
Last NPPES UpdateJuly 14, 20254 updates tracked since enumeration
NPPES CertifiedJuly 14, 2025
✔ NPI 1174874200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X
999 RIVERVIEW DR FL 2, Totowa, NJ 07512
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 31D2164200

Evernorth Care Providers- New Jersey PC · Totowa, NJ
Active · expires Mar 28, 2027
CLIA Number31D2164200
Laboratory TypeIn-Home Primary Care
Certificate Effective DateMarch 29, 2025
Certificate Expiration DateMarch 28, 2027
Laboratory DirectorCheryl Hilton
Laboratory Phone(877) 663-1333
Laboratory LocationEvernorth Care Providers- New Jersey PC999 Riverview Drive 2nd Floor, Totowa, NJ 07512
CLIA data matches this NPI record on: 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.

MEGAN DENOS
Dietitian, Registered
999 RIVERVIEW DR FL 2
TOTOWA, NJ 07512
Passaic County (609) 605-0249

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 Care Providers - New Jersey PC's NPI number?

The NPI number for Evernorth Care Providers - New Jersey PC is 1174874200. It was assigned to this organization in the NPPES registry on September 28, 2012.

Where is Evernorth Care Providers - New Jersey PC located?

Evernorth Care Providers - New Jersey PC is located at 999 Riverview Dr Fl 2, Totowa, NJ 07512. The listed phone number is (773) 292-4800.

What is Evernorth Care Providers - New Jersey PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Evernorth Care Providers - New Jersey PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2164200) is associated with this NPI, valid through March 28, 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 Care Providers - New Jersey PC was last updated on July 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.