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NPI 1700300209

NPI 1700300209 : EVERSIDE HEALTH, LLC : CINCINNATI, OH

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General NPI Number Information
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    NPI Number           |    1700300209
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    Entity Type          |    Organization 
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    Legal Business Name  |    EVERSIDE HEALTH, LLC 
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Dates
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    Enumeration Date     |    07/27/2017
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    Last Update Date     |    04/14/2025
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Provider Practice Location Address
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    Address Line         |    212 CROWNE POINT PL STE 103 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45241-1388
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    Country              |    US
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    Telephone            |    513-326-2890
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    Fax                  |    833-973-4906
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Provider Business Mailing Address
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    Address Line         |    4651 CHARLOTTE PARK DR STE 300 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28217-1916
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR OF RISK MANAGEMENT
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    Name                 |     JILL JOHNSON PATTON 
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    Credential           |    
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    Telephone            |    704-936-5546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QP2300X
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    Taxonomy Name        |    Primary Care Clinic/Center
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    License Number       |    
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    License Number State |    
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