Evernorth Care Providers - Tennessee PC
NPI 1356128904ActiveOrganization· General Practice· Birmingham, AL
General Practice in Birmingham, Alabama, registered in NPPES in September 2023. The authorized official on file is Jacqueline D. Lakes, Senior Parlalegal.
Overview
| NPI | 1356128904 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 8, 2023 |
| Last updated in NPPES | Jul 14, 2025 |
| Certified by provider | Jul 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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