1. Home
  2. Directory
  3. Illinois
  4. Peoria
  5. Clinic Center
  6. NPI Profile

ACTIVATE HEALTHCARE.
NPI 1922646686
Clinic/Center - Primary Care in Peoria, IL

Active since December 12, 2019CLIA 14D2177658 · Waiver
1524 W GLEN AVE, PEORIA, IL 61614(309) 512-0902 Get Directions Write a Review

NPPES record last updated: August 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 12, 2022, Mar 5, 2020, Dec 12, 2019 (3 updates tracked since 2019).

About Activate Healthcare. NPPES

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

ACTIVATE HEALTHCARE. (NPI 1922646686) is a healthcare organization registered as a primary care in Peoria, Illinois and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through January 14, 2028 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1922646686
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEVERSIDE HEALTH, LLC
Location Address1524 W GLEN AVEPeoria, IL 61614-4692
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Phone(309) 512-0902
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateDecember 12, 2019
Last NPPES UpdateAugust 12, 20223 updates tracked since enumeration
NPPES CertifiedAugust 12, 2022
✔ NPI 1922646686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1524 W GLEN AVE, Peoria, IL 61614
Open in Google Maps ↗

Other Names 1

Doing Business AsActivate Healthcare.

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 14D2177658

Everside Health Peoria Clinic (pps) · Peoria, IL
Active · expires Jan 14, 2028
CLIA Number14D2177658
Laboratory TypePhysician Office
Certificate Effective DateJanuary 15, 2026
Certificate Expiration DateJanuary 14, 2028
Laboratory DirectorMichael Springer
Laboratory Phone(309) 512-0902
Laboratory LocationEverside Health Peoria Clinic (pps)1524 W Glen Ave, Peoria, IL 61614
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 9

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

BENNINGFIELD & ASSOCIATES, LLC
Chiropractor
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 692-6800
MARK K WERKING, DC, SC
Chiropractor
1524 W GLEN AVE, STE B
PEORIA, IL 61614
Peoria County (309) 692-2121
MS. AMBER KAY JONES MSN, APRN, FNP-BC
Nurse Practitioner (Family)
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 512-0902
DR. ROBERT CRAIG BENNINGFIELD DC
Chiropractor
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 692-6800
DR. SCOTT C FENWICK DC
Chiropractor
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 692-6800
DR. JASON RYAN BENNINGFIELD D.C.
Chiropractor
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 692-6800
MRS. MEGHAN K CHOCKLEY PT
Physical Therapist
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 692-6800
MR. KIM KEITH WIESE PA-C
Physician Assistant
1524 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 512-0902

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 1922646686. It was assigned to this organization in the NPPES registry on December 12, 2019. The provider is doing business as Activate Healthcare..

Where is Everside Health, LLC located?

Everside Health, LLC is located at 1524 W Glen Ave, Peoria, IL 61614. The listed phone number is (309) 512-0902.

What is Everside Health, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Everside Health, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2177658) is associated with this NPI, valid through January 14, 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 August 12, 2022. 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.