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EVERNORTH DIRECT HEALTH LLC
NPI 1245920131
Clinic/Center in Bridgeport, AL

Active since May 12, 2023CLIA 01D2156953 · Waiver
202 JACOBS AVE, BRIDGEPORT, AL 35740(256) 495-2928(256) 495-2928 Get Directions Write a Review

NPPES record last updated: May 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 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 1245920131) is a healthcare organization registered as a clinic/center in Bridgeport, Alabama and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through October 28, 2026 and lists Deborah Sue Coolidge, Financial Analysis Senior Manager, as its authorized official.

NPPES Registry Identity

NPI1245920131
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameEVERNORTH DIRECT HEALTH LLC
Location Address202 JACOBS AVEBridgeport, AL 35740-6682
Mailing Address8888 E Raintree DrScottsdale, AZ 85260-3951
Phone(256) 495-2928
Fax(256) 495-2928
Organization SubpartYes
Authorized OfficialDeborah Sue CoolidgeFinancial Analysis Senior Manager · (623) 277-1170
Enumeration DateMay 12, 2023
NPPES CertifiedMay 12, 2023
✔ NPI 1245920131 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).
202 JACOBS AVE, Bridgeport, AL 35740
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Other Names 1

Other NameMohawk Hlc Bridgeport

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 01D2156953

Evernorth Direct Health LLC Bridgeport Healthy Life Center · Bridgeport, AL
Active · expires Oct 28, 2026
CLIA Number01D2156953
Laboratory TypeOut Patient
Certificate Effective DateOctober 29, 2024
Certificate Expiration DateOctober 28, 2026
Laboratory DirectorMrs. Misty Chessor
Laboratory Phone(480) 868-0646
Laboratory LocationEvernorth Direct Health LLC Bridgeport Healthy Life Center202 Jacobs Avenue, Bridgeport, AL 35740
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 1245920131. It was assigned to this organization in the NPPES registry on May 12, 2023. The provider is also known as Mohawk HLC Bridgeport.

Where is Evernorth Direct Health LLC located?

Evernorth Direct Health LLC is located at 202 Jacobs Ave, Bridgeport, AL 35740. The listed phone number is (256) 495-2928.

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 01D2156953) is associated with this NPI, valid through October 28, 2026. 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 May 12, 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.