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EVERNORTH CARE PROVIDERS - TENNESSEE PC
NPI 1821869835
General Practice in Durham, NC

Active since January 10, 2024CLIA 34D2318172 · Waiver
555 S MANGUM ST STE 100, DURHAM, NC 27701(773) 292-4800(312) 564-4059 Get Directions Write a Review

NPPES record last updated: February 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Evernorth Care Providers - Tennessee Pc NPPES

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

EVERNORTH CARE PROVIDERS - TENNESSEE PC (NPI 1821869835) is a healthcare organization registered as a general practice in Durham, North Carolina and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through February 5, 2027 and lists Grace Blue, Credentialing Sr. Manager, as its authorized official.

NPPES Registry Identity

NPI1821869835
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameEVERNORTH CARE PROVIDERS - TENNESSEE PC
Location Address555 S MANGUM ST STE 100Durham, NC 27701-4689
Mailing Address730 Cool Springs Blvd Ste 500Franklin, TN 37067-7331 · (773) 292-4800 · Fax (312) 564-4059
Phone(773) 292-4800
Fax(312) 564-4059
Organization SubpartNo
Authorized OfficialGrace BlueCredentialing Sr. Manager · (773) 292-4800
Enumeration DateJanuary 10, 2024
Last NPPES UpdateFebruary 14, 2024
NPPES CertifiedFebruary 14, 2024
✔ NPI 1821869835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
555 S MANGUM ST STE 100, Durham, NC 27701
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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 34D2318172

Evernorth Care Providers - Tennessee PC · Durham, NC
Active · expires Feb 5, 2027
CLIA Number34D2318172
Laboratory TypeIn Home Primary Care
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorCheryl Hilton
Laboratory Phone(877) 663-1333
Laboratory LocationEvernorth Care Providers - Tennessee PC555S Magnum Street, Suite 100, Durham, NC 27701
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 18

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

CARECONNECTMD NORTH CAROLINA P.C.
General Practice
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (888) 789-9585
HEALING CONNECTIONS - CENTER FOR MIND AND BODY PLLC
Clinic/Center (Health Service)
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (919) 525-1627
ICARE THERAPY NC LLC
Behavior Analyst
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (866) 588-8829
MICHAEL BURROUGHS PLLC
Social Worker (Clinical)
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (984) 377-2877
SUCCEED ABA NC LLC
Community/Behavioral Health
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (463) 777-8323
BROOKIEL COMMUNITY SERVICES, INC
Community/Behavioral Health
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (919) 619-6509
OLE CREEK HEALTH AND WELLNESS INC
Home Health
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (984) 358-8100
DR. KENNEDY PARON
Behavior Analyst
555 S MANGUM ST STE 100
DURHAM, NC 27701
Durham County (248) 238-7341

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 - Tennessee PC's NPI number?

The NPI number for Evernorth Care Providers - Tennessee PC is 1821869835. It was assigned to this organization in the NPPES registry on January 10, 2024.

Where is Evernorth Care Providers - Tennessee PC located?

Evernorth Care Providers - Tennessee PC is located at 555 S Mangum St Ste 100, Durham, NC 27701. The listed phone number is (773) 292-4800.

What is Evernorth Care Providers - Tennessee PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Evernorth Care Providers - Tennessee PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2318172) is associated with this NPI, valid through February 5, 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 Evernorth Care Providers - Tennessee PC was last updated on February 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.