EVERNORTH DIRECT HEALTH LLC
NPI 1063063089
Clinic/Center in Fort Myers, FL
NPI Status: Active since September 20, 2019
Contact Information
14311 METROPOLIS AVE STE 102
FORT MYERS, FL
ZIP 33912
Phone: (239) 768-0127
Fax: (239) 768-0671
- Organization
- Clinic/Center
- CLIA Number: 10D2031194
- CLIA Cert. Type: Other - OUTPATIENT
- CLIA Exp. Date: 10-13-2025
About EVERNORTH DIRECT HEALTH LLC
This page provides the complete NPI Profile along with additional information for Evernorth Direct Health Llc, a provider established in Fort Myers, Florida operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1063063089 assigned on September 2019. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Deborah Sue Coolidge (Financial Analysis Senior Manager)
- NPI
- 1063063089
- Provider Name
- EVERNORTH DIRECT HEALTH LLC
- Entity Type
- Organization
- Location Address
- 14311 METROPOLIS AVE STE 102 FORT MYERS, FL 33912
- Location Phone
- (239) 768-0127
- Location Fax
- (239) 768-0671
- Mailing Address
- 25600 N NORTERRA DR PHOENIX, AZ 85085
- Mailing Phone
- (623) 277-1190
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-20-2019
- Last Update Date
- 05-03-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2031194
- Facility Type
- Other - OUTPATIENT
- Certificate Effective Date
- October 14, 2023
- Certificate Expiration Date
- October 13, 2025
- Laboratory Director
- DANIELLE FAULKNER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evernorth Direct Health Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for EVERNORTH DIRECT HEALTH LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 6 | 3 | 0 | 6 | 3 | 0 | 8 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 12 | 3 | 0 | 6 | 6 | 0 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 2 + 3 + 0 + 6 + 6 + 0 + 1 + 6 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1063063089 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1487095980 | JOSEPH HIRAM LEAMAN D.O. Individual | Family Medicine | 14311 METROPOLIS AVE STE 102 FORT MYERS, FL 33912 (239) 768-0127 |
| 1083140081 | DR. SHAYNA SMALLWOOD M.D. Individual | Family Medicine | 14311 METROPOLIS AVE STE 102 FORT MYERS, FL 33912 (239) 768-0127 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063063089, enumerated in the NPI registry as an "organization" on September 20, 2019
The provider is located at 14311 Metropolis Ave Ste 102 Fort Myers, Fl 33912 and the phone number is (239) 768-0127
This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X
The provider's CLIA number is 10D2031194 for a "other - outpatient" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on September 20, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.