EVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION
NPI 1205234291
Family Medicine in Melville, NY

Q: What is Evernorth Medical Care Providers New York Professional Corporation's specialty?

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

Active since December 08, 2014

555 BROADHOLLOW RD STE 305, MELVILLE, NY 11747(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 16, 2026.

Record update history: Jan 25, 2023, Dec 14, 2022, Jun 16, 2021 (3 updates tracked since 2021).

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About Evernorth Medical Care Providers New York Professional Corporation NPPES

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

EVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION (NPI 1205234291), doing business as Dirk Wales Md Pc, is a healthcare organization registered as a family medicine in Melville, New York and active in the NPI registry since December 2014. The organization lists Jacqueline D Lakes, Senior Paralegal, as its authorized official.

NPPES Registry Identity

NPI1205234291

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameEVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION

Location Address555 BROADHOLLOW RD STE 305Melville, NY 11747-5018

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 DateDecember 8, 2014

Last NPPES UpdateJuly 14, 20253 updates tracked since enumeration

NPPES CertifiedJuly 14, 2025

✔ NPI 1205234291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ 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.

Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X

Also ListedFamily Medicine · Hospice and Palliative MedicineTaxonomy 207QH0002X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X

Also ListedPodiatristTaxonomy 213E00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

555 BROADHOLLOW RD STE 305, Melville, NY 11747

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Other Names 1

Former Legal Business NameDirk Wales Md Pc

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

Other Providers at the Same Location NPPES 5

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

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