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EVERSIDE HEALTH, LLC
NPI 1982078705
Clinic/Center - Primary Care in St. Henry, OH

Active since November 17, 2015CLIA 36D2126668 · Waiver
640 EAST MAIN STREET, ST. HENRY, OH 45883(419) 763-4133(419) 763-4163 Get Directions Write a Review

NPPES record last updated: August 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 12, 2022, Nov 17, 2015 (2 updates tracked since 2015).

About Everside Health, Llc NPPES

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

EVERSIDE HEALTH, LLC (NPI 1982078705) is a healthcare organization registered as a primary care in St. Henry, Ohio and active in the NPI registry since November 2015. The organization holds a CLIA Waiver certificate valid through March 1, 2027 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1982078705
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEVERSIDE HEALTH, LLC
Location Address640 EAST MAIN STREETSt. Henry, OH 45883
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Phone(419) 763-4133
Fax(419) 763-4163
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateNovember 17, 2015
Last NPPES UpdateAugust 12, 20222 updates tracked since enumeration
NPPES CertifiedAugust 12, 2022
✔ NPI 1982078705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
640 EAST MAIN STREET, St. Henry, OH 45883
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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 36D2126668

Everside Health Cooper Farms Saint Henry Clinic · Saint Henry, OH
Active · expires Mar 1, 2027
CLIA Number36D2126668
Laboratory TypePhysician Office
Certificate Effective DateMarch 2, 2025
Certificate Expiration DateMarch 1, 2027
Laboratory DirectorKalyan Aluri
Laboratory Phone(704) 529-6161
Laboratory LocationEverside Health Cooper Farms Saint Henry Clinic640 E Main Street, Saint Henry, OH 45883
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 1982078705. It was assigned to this organization in the NPPES registry on November 17, 2015.

Where is Everside Health, LLC located?

Everside Health, LLC is located at 640 East Main Street, St. Henry, OH 45883. The listed phone number is (419) 763-4133.

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 36D2126668) is associated with this NPI, valid through March 1, 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 Everside Health, LLC was last updated on August 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.