EVERNORTH CARE PROVIDERS - DELAWARE PA
NPI 1437803012
Internal Medicine in East Berlin, CT

Active since February 11, 2022CLIA 07D2310351 · Waiver
1224 MILL ST STE 224, EAST BERLIN, CT 06023(773) 292-4800(312) 564-4059 Get Directions Write a Review

NPPES record last updated: January 22, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 7, 2023, Mar 7, 2022, Feb 11, 2022 (3 updates tracked since 2022).

About Evernorth Care Providers - Delaware Pa NPPES

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

EVERNORTH CARE PROVIDERS - DELAWARE PA (NPI 1437803012) is a healthcare organization registered as an internal medicine in East Berlin, Connecticut and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through September 2, 2026 and lists Grace V Blue, Credentialing Sr. Manager, as its authorized official.

NPPES Registry Identity

NPI1437803012
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameEVERNORTH CARE PROVIDERS - DELAWARE PA
Location Address1224 MILL ST STE 224East Berlin, CT 06023-1159
Mailing Address730 Cool Springs Blvd Ste 500Franklin, TN 37067-7331 · (773) 292-4800 · Fax (312) 564-4059
Fax(312) 564-4059
Organization SubpartNo
Authorized OfficialGrace V BlueCredentialing Sr. Manager · (773) 292-4800
Enumeration DateFebruary 11, 2022
Last NPPES UpdateJanuary 22, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2024
NPI 1437803012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X
1224 MILL ST STE 224, East Berlin, CT 06023

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 07D2310351

Evernorth Care Providers -Delaware PA · East Berlin, CT
Active · expires Sep 2, 2026
CLIA Number07D2310351
Laboratory TypeIn Home Primary Care
Certificate Effective DateSeptember 3, 2024
Certificate Expiration DateSeptember 2, 2026
Laboratory DirectorShannon Alsop
Laboratory Phone(877) 663-1333
Laboratory LocationEvernorth Care Providers -Delaware PA1224 Mill Street, Bldg B Suite 224, East Berlin, CT 06023
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

Social Worker (Clinical)
1224 MILL ST STE 224
EAST BERLIN, CT 06023
Social Worker (Clinical)
1224 MILL ST STE 224
EAST BERLIN, CT 06023
Technician, Pathology (Phlebotomy)
1224 MILL ST STE 224
EAST BERLIN, CT 06023
Clinical Medical Laboratory
1224 MILL ST STE 224
EAST BERLIN, CT 06023
Physician Assistant
1224 MILL ST STE 224
EAST BERLIN, CT 06023
Physician Assistant
1224 MILL ST STE 224
EAST BERLIN, CT 06023

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 Care Providers - Delaware PA's NPI number?

The NPI number for Evernorth Care Providers - Delaware PA is 1437803012. It was assigned to this organization in the NPPES registry on February 11, 2022.

Where is Evernorth Care Providers - Delaware PA located?

Evernorth Care Providers - Delaware PA is located at 1224 Mill St Ste 224, East Berlin, CT 06023. The listed phone number is (773) 292-4800.

What is Evernorth Care Providers - Delaware PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Evernorth Care Providers - Delaware PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2310351) is associated with this NPI, valid through September 2, 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 Care Providers - Delaware PA was last updated on January 22, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.