| Evernorth Care Providers - Delaware Pa | |
|
8044 Montgomery Rd Ste 700 Cincinnati OH 45236-2926 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Delaware Pa |
|---|---|
| Speciality | General Practice |
| Location | 8044 Montgomery Rd Ste 700, Cincinnati, Ohio |
| 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 8044 Montgomery Rd Ste 700 Cincinnati OH 45236-2926 Ph: (773) 292-4800 |
| NPI Number | 1801670435 |
|---|---|
| Provider Enumeration Date | 08/23/2023 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 6002217973 |
|---|---|
| Medicare Enrollment ID | O20231214003006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801670435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Maria Rajki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972679546 PECOS PAC ID: 3375687387 Enrollment ID: I20100215000210 |
| Provider Name | Toimeicka La June Worthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881746410 PECOS PAC ID: 7517267461 Enrollment ID: I20151124002523 |
| Provider Name | Walinda Davis-jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376791723 PECOS PAC ID: 3779913017 Enrollment ID: I20200428001990 |
| Provider Name | Shannon Alsop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003043803 PECOS PAC ID: 7517121742 Enrollment ID: I20231214003258 |
| Provider Name | Cheryl Hilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184677742 PECOS PAC ID: 4082683651 Enrollment ID: I20240103000773 |
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