| Evernorth Care Providers - Delaware Pa | |
|
67 Merchants Row Ste 201 Rutland VT 05701-5938 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Delaware Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 67 Merchants Row Ste 201, Rutland, Vermont |
| Authorized Official Name and Position | Grace V Blue (CREDENTIALING SR. MANAGER) |
| Authorized Official Contact | 7732924800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evernorth Care Providers - Delaware Pa 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Delaware Pa 67 Merchants Row Ste 201 Rutland VT 05701-5938 Ph: (773) 292-4800 |
| NPI Number | 1215675327 |
|---|---|
| Provider Enumeration Date | 05/27/2022 |
| Last Update Date | 02/21/2024 |
| Medicare PECOS PAC ID | 6002217973 |
|---|---|
| Medicare Enrollment ID | O20220817000497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215675327 | NPI | - | NPPES |
| Provider Name | Kristal L Imperio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780650234 PECOS PAC ID: 4789624214 Enrollment ID: I20190726000515 |
| Provider Name | Tiffany Lingenfelter Pierce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275612426 PECOS PAC ID: 8123119914 Enrollment ID: I20220817000587 |
| Provider Name | Breana Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912504176 PECOS PAC ID: 3173923232 Enrollment ID: I20220907000197 |
| Provider Name | Lida E Mohammadkhah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205137569 PECOS PAC ID: 8628238839 Enrollment ID: I20220907000330 |
| Provider Name | Adeola Babarinde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790062420 PECOS PAC ID: 6709052889 Enrollment ID: I20220913001630 |
| Provider Name | Laura Cummings-payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144578634 PECOS PAC ID: 1153631437 Enrollment ID: I20220923002322 |
| Provider Name | Sharon Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316014822 PECOS PAC ID: 4385714146 Enrollment ID: I20220930000233 |
| Provider Name | Mercy Olumuyiwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598129504 PECOS PAC ID: 4082903620 Enrollment ID: I20221116003102 |
| Provider Name | Stacy Rohr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396410163 PECOS PAC ID: 8426455569 Enrollment ID: I20231019002682 |
| Provider Name | Norah Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932466372 PECOS PAC ID: 8628220662 Enrollment ID: I20231027000778 |
| Provider Name | Ruby Uwaeme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649617465 PECOS PAC ID: 9436477288 Enrollment ID: I20231101002995 |
| Provider Name | Shannon Alsop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003043803 PECOS PAC ID: 7517121742 Enrollment ID: I20231214003286 |
| Provider Name | Sabrina Elien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902373905 PECOS PAC ID: 9133581804 Enrollment ID: I20240119002215 |
| Provider Name | Lasonya Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003488164 PECOS PAC ID: 3173913365 Enrollment ID: I20240210000107 |
| Provider Name | Talphineta Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285107318 PECOS PAC ID: 7719313642 Enrollment ID: I20240319001219 |
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Plume Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Merchants Row Ste 212, Rutland, VT 05701 Phone: 720-248-4483 | |
Michael Garcia Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 Commons St, Rutland, VT 05701 Phone: 802-773-1321 | |
Common Street Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 Commons St, Rutland, VT 05701 Phone: 802-773-1321 | |
True Care Vermont, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9 Commons St, Rutland, VT 05701 Phone: 802-779-7522 Fax: 802-747-4061 | |
Associates In Internal Medicine, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 254 Stratton Rd, Suite 2, Rutland, VT 05701 Phone: 802-775-5531 Fax: 802-773-4697 |