EVERSIDE HEALTH, LLC
NPI 1265053862
Clinic/Center - Health Service in East Peoria, IL

Active since May 05, 2020CLIA 14D2182526 · Waiver
204 W WASHINGTON ST, EAST PEORIA, IL 61611(309) 322-6874 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 28, 2022, May 5, 2020 (2 updates tracked since 2020).

About Everside Health, Llc NPPES

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

EVERSIDE HEALTH, LLC (NPI 1265053862) is a healthcare organization registered as a health service in East Peoria, Illinois and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through April 21, 2028 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1265053862
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameEVERSIDE HEALTH, LLC
Location Address204 W WASHINGTON STEast Peoria, IL 61611-2477
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateMay 5, 2020
Last NPPES UpdateJuly 28, 20222 updates tracked since enumeration
NPPES CertifiedJuly 28, 2022
NPI 1265053862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
204 W WASHINGTON ST, East Peoria, IL 61611

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 14D2182526

Everside Health - East Peoria · East Peoria, IL
Active · expires Apr 21, 2028
CLIA Number14D2182526
Laboratory TypePhysician Office
Certificate Effective DateApril 22, 2026
Certificate Expiration DateApril 21, 2028
Laboratory DirectorJames Demmel
Laboratory Phone(309) 322-6874
Laboratory LocationEverside Health - East Peoria204 W Washington St, East Peoria, IL 61611
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 2

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

Nurse Practitioner (Family)
204 W WASHINGTON ST
EAST PEORIA, IL 61611
Nurse Practitioner (Family)
204 W WASHINGTON ST
EAST PEORIA, IL 61611

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, LLC's NPI number?

The NPI number for Everside Health, LLC is 1265053862. It was assigned to this organization in the NPPES registry on May 5, 2020.

Where is Everside Health, LLC located?

Everside Health, LLC is located at 204 W Washington St, East Peoria, IL 61611. The listed phone number is (309) 322-6874.

What is Everside Health, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Everside Health, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2182526) is associated with this NPI, valid through April 21, 2028. 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, LLC was last updated on July 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.