EVERSIDE HEALTH-DANVILLE LOGAN AVENUE
NPI 1215620893
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Danville, IL

Active since May 31, 2023CLIA 14D2286300 · Waiver
603 N LOGAN AVE, DANVILLE, IL 61832(704) 661-1380 Get Directions Write a Review

NPPES record last updated: May 31, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Everside Health-danville Logan Avenue NPPES

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

EVERSIDE HEALTH-DANVILLE LOGAN AVENUE (NPI 1215620893) is a healthcare organization registered as a preventive medicine/occupational environmental medicine in Danville, Illinois and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through July 25, 2027 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1215620893
Entity TypeOrganization
Primary Taxonomy2083P0500X
Legal Business NameEVERSIDE HEALTH-DANVILLE LOGAN AVENUE
Location Address603 N LOGAN AVEDanville, IL 61832-4320
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateMay 31, 2023
NPPES CertifiedMay 31, 2023
NPI 1215620893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPreventive Medicine · Preventive Medicine/Occupational Environmental MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0500X
Definition
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
603 N LOGAN AVE, Danville, IL 61832

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 14D2286300

Everside Health Danville Logan Avenue · Danville, IL
Active · expires Jul 25, 2027
CLIA Number14D2286300
Laboratory TypePhysician Office
Certificate Effective DateJuly 26, 2025
Certificate Expiration DateJuly 25, 2027
Laboratory DirectorMichael Willhite
Laboratory Phone(704) 661-1380
Laboratory LocationEverside Health Danville Logan Avenue603 N Logan Ave, Danville, IL 61832
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Clinic/Center (Primary Care)
603 N LOGAN AVE
DANVILLE, IL 61832
Nurse Practitioner (Family)
603 N LOGAN AVE
DANVILLE, IL 61832
Nurse Practitioner (Adult Health)
603 N LOGAN AVE
DANVILLE, IL 61832

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-Danville Logan Avenue's NPI number?

The NPI number for Everside Health-Danville Logan Avenue is 1215620893. It was assigned to this organization in the NPPES registry on May 31, 2023.

Where is Everside Health-Danville Logan Avenue located?

Everside Health-Danville Logan Avenue is located at 603 N Logan Ave, Danville, IL 61832. The listed phone number is (704) 661-1380.

What is Everside Health-Danville Logan Avenue's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

Does Everside Health-Danville Logan Avenue hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2286300) is associated with this NPI, valid through July 25, 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 Everside Health-Danville Logan Avenue was last updated on May 31, 2023. 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.