Evernorth Care Providers - Tennessee PC
NPI 1174304976 · General Practice Physician · Fairfax, VA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Evernorth Care Providers - Tennessee PC is a General Practice Physician organization in Fairfax, VA (NPI 1174304976).
Provider details
- NPI number
- 1174304976
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jacqueline Lakes, Senior Paralegal(954) 446-0640
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-10-09
- Last updated
- 2025-07-14
- Certified
- 2025-07-14
Frequently asked questions
- What is Evernorth Care Providers - Tennessee PC's NPI number?
- Evernorth Care Providers - Tennessee PC's National Provider Identifier (NPI) is 1174304976, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evernorth Care Providers - Tennessee PC?
- Evernorth Care Providers - Tennessee PC is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Evernorth Care Providers - Tennessee PC located?
- Evernorth Care Providers - Tennessee PC's practice location on file with NPPES is 11350 Random Hills Rd Ste 800, Fairfax, VA 22030-6044.
- What is Evernorth Care Providers - Tennessee PC's phone number?
- The practice phone number listed in the NPPES registry for Evernorth Care Providers - Tennessee PC is (773) 292-4800.
- Does Evernorth Care Providers - Tennessee PC accept Medicare?
- Evernorth Care Providers - Tennessee PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Evernorth Care Providers - Tennessee PC?
- The authorized official listed on Evernorth Care Providers - Tennessee PC's NPPES record is Jacqueline Lakes, Senior Paralegal. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evernorth Care Providers - Tennessee PC's NPI active?
- Yes — Evernorth Care Providers - Tennessee PC's NPI (1174304976) is active in the NPPES registry as of the last update on 2025-07-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.