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

NPI Status: Active since May 05, 2020

Contact Information

204 W WASHINGTON ST
EAST PEORIA, IL
ZIP 61611
Phone: (309) 322-6874

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  • Organization
  • Clinic/Center
  • Health Service
  • CLIA Number: 14D2182526
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-21-2028

About EVERSIDE HEALTH, LLC

This page provides the complete NPI Profile along with additional information for Everside Health, Llc, a provider established in East Peoria, Illinois operating as a Clinic/center, focusing in health service . The healthcare provider is registered in the NPI registry with number 1265053862 assigned on May 2020. The practitioner's primary taxonomy code is 261QH0100X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Jill Johnson Patton (Director Of Risk Management)

NPI
1265053862
Provider Name
EVERSIDE HEALTH, LLC
Entity Type
Organization
Location Address
204 W WASHINGTON ST EAST PEORIA, IL 61611
Location Phone
(309) 322-6874
Mailing Address
4651 CHARLOTTE PARK DR STE 300 CHARLOTTE, NC 28217
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-05-2020
Last Update Date
07-28-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Health Service

Taxonomy Code
261QH0100X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JILL JOHNSON PATTON

Authorized Official Title
DIRECTOR OF RISK MANAGEMENT
Authorized Official Phone
(704) 936-5546

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2182526
Facility Type
Physician Office
Certificate Effective Date
April 22, 2026
Certificate Expiration Date
April 21, 2028
Laboratory Director
JAMES DEMMEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Everside Health, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1265053862, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
3
Doubled → 6
Pos 8
8
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 0 → 0 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 0 + 5 + 6 + 8 + 1 + 2 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1265053862.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

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

The NPI number assigned to this healthcare provider is 1265053862, enumerated as an "organization" on May 05, 2020.

The provider is located at 204 W WASHINGTON ST EAST PEORIA, IL 61611 and the phone number is (309) 322-6874.

Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.