KTV Alive

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

KTV ALIVE

Practice address

1665 Lower Moncure Road
Sanford, NC 27330-6403

Phone

(919) 774-1135

NPI assigned

Dec 10, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phaedra N Taylor

Title

Director

Phone

(919) 774-1135

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1013210129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3284",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273312384",
            "telephone_number": "919-772-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 LOWER MONCURE ROAD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306403",
            "telephone_number": "919-774-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KTV ALIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "PHAEDRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-774-1135"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moya Chin Kombrinck, M.D.
• Erica Konopka, DPT
• Katherine Serafen Koonce, PA-C
• Leonard K Kovalick, PNP
• Erin Kraus
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• Prabhat Kumar, M.D.
• KV Health Technologies
• Richard Teye Kwao, PAC
• L.J. Choices, Inc.

• Foster Care Agency in Sanford, NC
• Providers in Sanford, NC by specialty
• Foster Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.