# EVERSIDE HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Virtual Health Center East
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134886203
- **Authorized official:** JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
- **Authorized official phone:** (704) 936-5546

## Contact information

- **Practice address:** 1640 CAMPUS PARK DR STE A, MONROE, NC 28112-5284
- **Practice address phone:** (866) 808-6005
- **Mailing address:** 4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/23/2021
- **Last updated:** 10/19/2022