Evernorth Care Providers - Tennessee Pc | |
4700 Millenia Blvd Ste 5005th Orlando FL 32839-6013 | |
(773) 292-4800 | |
(312) 564-4059 |
Full Name | Evernorth Care Providers - Tennessee Pc |
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Speciality | General Practice |
Location | 4700 Millenia Blvd Ste 5005th, Orlando, Florida |
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 |
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Evernorth Care Providers - Tennessee Pc 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Tennessee Pc 4700 Millenia Blvd Ste 5005th Orlando FL 32839-6013 Ph: (773) 292-4800 |
NPI Number | 1316726730 |
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Provider Enumeration Date | 09/25/2023 |
Last Update Date | 02/14/2024 |
Medicare PECOS PAC ID | 7911355532 |
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Medicare Enrollment ID | O20231121000124 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316726730 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Virginia R Lemoyne |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699905240 PECOS PAC ID: 7618014705 Enrollment ID: I20091021000844 |
Provider Name | Holly Trinque |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881750487 PECOS PAC ID: 8123217460 Enrollment ID: I20110118000884 |
Provider Name | Ashley Wambolt Mccormick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811328099 PECOS PAC ID: 8123257334 Enrollment ID: I20140211001293 |
Provider Name | Sarah E Goodman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417203845 PECOS PAC ID: 6800028424 Enrollment ID: I20140415000392 |
Provider Name | Norah Harris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932466372 PECOS PAC ID: 8628220662 Enrollment ID: I20151028000012 |
Provider Name | Kari K O'neal |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255887626 PECOS PAC ID: 8123306982 Enrollment ID: I20170202002360 |
Provider Name | Brianne Jane Freel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134630197 PECOS PAC ID: 8628328606 Enrollment ID: I20180912003430 |
Provider Name | Erika Cruz-martinez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396258554 PECOS PAC ID: 6406192046 Enrollment ID: I20190118000039 |
Provider Name | Anisley Robaina |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124584818 PECOS PAC ID: 3072854967 Enrollment ID: I20190402001310 |
Provider Name | Rachel R Pawlenko |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336598101 PECOS PAC ID: 4688960479 Enrollment ID: I20190426000389 |
Provider Name | Stacey Hewitt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053856005 PECOS PAC ID: 1658653407 Enrollment ID: I20200316000304 |
Provider Name | Harold Plancher |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760002778 PECOS PAC ID: 8921424607 Enrollment ID: I20200812000645 |
Provider Name | Tammy Womack |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144850637 PECOS PAC ID: 8628489788 Enrollment ID: I20201202000843 |
Provider Name | Elisabeth Buchanan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356618748 PECOS PAC ID: 4789828526 Enrollment ID: I20210208000551 |
Provider Name | Daniela Cobb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790372167 PECOS PAC ID: 9739595455 Enrollment ID: I20210304000458 |
Provider Name | Roberta Slauterbeck |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841733854 PECOS PAC ID: 9830479534 Enrollment ID: I20210729001207 |
Provider Name | Sandra Ferriere |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184211476 PECOS PAC ID: 6103221957 Enrollment ID: I20210817004204 |
Provider Name | Stacy Rohr |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396410163 PECOS PAC ID: 8426455569 Enrollment ID: I20210916001431 |
Provider Name | Natalia Mysh |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679938237 PECOS PAC ID: 4183911456 Enrollment ID: I20211012002426 |
Provider Name | Elizabeth Lauren Mackenzie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841841558 PECOS PAC ID: 3678993516 Enrollment ID: I20220309003295 |
Provider Name | Jennifer Leigh Bart |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902553571 PECOS PAC ID: 5698160919 Enrollment ID: I20220322003137 |
Provider Name | Italia Cegla |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861139990 PECOS PAC ID: 8224418850 Enrollment ID: I20220629001374 |
Provider Name | Carthia Joachim |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265039820 PECOS PAC ID: 7214318914 Enrollment ID: I20220712003871 |
Provider Name | Sonia Lopez-moriarty |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831160175 PECOS PAC ID: 3971986340 Enrollment ID: I20220817002513 |
Provider Name | Ebony S Platt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215684675 PECOS PAC ID: 5092199513 Enrollment ID: I20220901002494 |
Provider Name | Chelsea Quaglia(tobin) |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659805422 PECOS PAC ID: 2466864244 Enrollment ID: I20221027001761 |
Provider Name | Lisa Shantel Newton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184158909 PECOS PAC ID: 3870963549 Enrollment ID: I20221221003194 |
Provider Name | Rebecca Ates |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467169854 PECOS PAC ID: 4082084579 Enrollment ID: I20221227001174 |
Provider Name | Talphineta Kelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285107318 PECOS PAC ID: 7719313642 Enrollment ID: I20230125001912 |
Provider Name | Debra Goodman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013325810 PECOS PAC ID: 3375859259 Enrollment ID: I20230314002089 |
Provider Name | Brittany Papanikolaou |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679286231 PECOS PAC ID: 0143685354 Enrollment ID: I20230421002391 |
Provider Name | Amy Bonanno |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902236698 PECOS PAC ID: 7214155647 Enrollment ID: I20230713000723 |
Provider Name | Sabrina Elien |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902373905 PECOS PAC ID: 9133581804 Enrollment ID: I20230811001173 |
Provider Name | Shannon Alsop |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003043803 PECOS PAC ID: 7517121742 Enrollment ID: I20231204000458 |
Provider Name | Cheryl Hilton |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184677742 PECOS PAC ID: 4082683651 Enrollment ID: I20231205000811 |
Provider Name | Oluwatobi Menawonu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891142774 PECOS PAC ID: 0941588628 Enrollment ID: I20231205001476 |
Provider Name | Charity Mugadza |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568715514 PECOS PAC ID: 6800040957 Enrollment ID: I20231229002381 |
Provider Name | Kayla Lunn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982001830 PECOS PAC ID: 9931524303 Enrollment ID: I20240216000652 |
Provider Name | Chirag Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043274772 PECOS PAC ID: 8921902651 Enrollment ID: I20240527000111 |
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