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EVERNORTH CARE PROVIDERS - TENNESSEE PC NPI 1356128904


NPI Information

NPI: 1356128904
Provider Name: EVERNORTH CARE PROVIDERS - TENNESSEE PC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 01D2301804

Address:
2700 CORPORATE DR STE 200
BIRMINGHAM, AL
ZIP 35242
Phone: (773) 292-4800
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EVERNORTH CARE PROVIDERS - TENNESSEE PC is a general practice in Birmingham, AL. The provider is 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 EVERNORTH CARE PROVIDERS - TENNESSEE PC NPI is 1356128904. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2700 CORPORATE DR STE 200
BIRMINGHAM, AL
ZIP 35242-733
Phone: (773) 292-4800
Fax: (312) 564-4059

The provider's authorized official is Grace V Blue .
The authorized official title is Credentialing Sr. Manager and has the following contact phone number (773) 292-4800.

The CLIA number assigned to this NPI record is 01D2301804 - other - in home primary care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/8/2023 and was last updated on 2/14/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.