Divine Connection of Durham, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

DIVINE CONNECTION OF DURHAM, LLC

Practice address

3201 Yorktown Ave Ste 107
Durham, NC 27713-1474

Phone

(919) 949-8835

NPI assigned

Apr 16, 2009

Organization subpart

No

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

Authorized official

Name

Carine Fuller

Title

Sole Member

Phone

(919) 806-1300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1073756326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 YORKTOWN AVE STE 107",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277131474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 YORKTOWN AVE STE 107",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277131474",
            "telephone_number": "919-949-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CONNECTION OF DURHAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "CARINE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "919-806-1300"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Divine Intervention
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• Divineconnectionhomecareagency,LLC
• Mrunmayi Diwan, PA-C
• Amy Ellis Dixon, CNM, MSN

• Case Management Agency in Durham, NC
• Providers in Durham, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.