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EVERNORTH DIRECT HEALTH LLC
NPI 1205547023
Clinic/Center in Dalton, GA

Active since December 13, 2022CLIA 11D2058391 · Waiver
2001 ANTIOCH RD, DALTON, GA 30721(706) 275-7660(706) 275-0013 Get Directions Write a Review

NPPES record last updated: December 13, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Evernorth Direct Health Llc NPPES

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

EVERNORTH DIRECT HEALTH LLC (NPI 1205547023) is a healthcare organization registered as a clinic/center in Dalton, Georgia and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through May 6, 2027 and lists Deborah Sue Coolidge, Financial Analysis Senior Manager, as its authorized official.

NPPES Registry Identity

NPI1205547023
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameEVERNORTH DIRECT HEALTH LLC
Location Address2001 ANTIOCH RDDalton, GA 30721-4622
Mailing Address25600 N Norterra DrPhoenix, AZ 85085-8201
Phone(706) 275-7660
Fax(706) 275-0013
Organization SubpartYes
Authorized OfficialDeborah Sue CoolidgeFinancial Analysis Senior Manager · (623) 277-1170
Enumeration DateDecember 13, 2022
NPPES CertifiedDecember 9, 2022
✔ NPI 1205547023 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).
2001 ANTIOCH RD, Dalton, GA 30721
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Other Names 1

Other NameMohawk Hlc Antioch

CLIA Laboratory Certificates CMS CLIA 2

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 11D2058391

Hthy Life Care Ctr-Green Street Dba Evernorth Direct Health · Dalton, GA
Active · expires May 6, 2027
CLIA Number11D2058391
Laboratory TypeOutpatient
Certificate Effective DateMay 7, 2025
Certificate Expiration DateMay 6, 2027
Laboratory DirectorGabriela Guzman
Laboratory Phone(623) 277-1128
Laboratory LocationHthy Life Care Ctr-Green Street Dba Evernorth Direct Health508 East Morris Street, Dalton, GA 30721
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2058393

Healthy Life Center Dba Evernorth Direct Health LLC · Dalton, GA
Expired · Jul 28, 2026
CLIA Number11D2058393
Laboratory TypeOutpatient
Certificate Effective DateJuly 29, 2024
Certificate Expiration DateJuly 28, 2026
Laboratory DirectorGabriela Guzman
Laboratory Phone(480) 868-0646
Laboratory LocationHealthy Life Center Dba Evernorth Direct Health LLC2001 Antioch Road, Dalton, GA 30721
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 7

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

PAMELA J SIMMONS NP-C
Nurse Practitioner (Family)
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (706) 277-1100
KRISTEN KING
Nurse Practitioner (Family)
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (833) 402-8060
EVERNORTH DIRECT HEALTH LLC
Non-Pharmacy Dispensing Site
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (706) 275-7660
MS. BERTHA LUCIA WOAS PA-C
Physician Assistant (Medical)
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (706) 275-7660
EVERNORTH DIRECT HEALTH LLC
Clinic/Center
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (706) 275-7660
KIRSTY J ELWELL PA-C
Physician Assistant (Medical)
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (706) 275-7600
DESIREE MARIE RATHBURN PA-C
Physician Assistant
2001 ANTIOCH RD
DALTON, GA 30721
Whitfield County (706) 272-7600

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 1205547023. It was assigned to this organization in the NPPES registry on December 13, 2022. The provider is also known as Mohawk HLC Antioch.

Where is Evernorth Direct Health LLC located?

Evernorth Direct Health LLC is located at 2001 Antioch Rd, Dalton, GA 30721. The listed phone number is (706) 275-7660.

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 11D2058391) is associated with this NPI, valid through May 6, 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 December 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.