# EVERSIDE HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DAVITA DPC HOLDING, INC
- **Other names:** Everside Health - Pueblo Fortino Blvd, Marathon Health, Pueblo CO
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710365416
- **Legal business name:** DAVITA DPC HOLDING, INC
- **Authorized official:** JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
- **Authorized official phone:** (704) 936-5546

## Contact information

- **Practice address:** 1300 FORTINO BLVD STE C, PUEBLO, CO 81008-2078
- **Practice address phone:** (719) 404-5100
- **Mailing address:** 4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916
- **Mailing address phone:** (866) 808-6005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/13/2015
- **Last updated:** 09/28/2026