NPIMap

Organization Active NPI

Special K Enrichment, Inc

  • Developmentally Disabled Services Day Training Agency
  • Charlotte, NC
National Provider Identifier
1114346889
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
SPECIAL K ENRICHMENT, INC
Practice address
3828 Cobbleridge Drive
Charlotte, NC 28215
Phone
(704) 395-3987
Fax
(704) 395-9436
NPI assigned
Apr 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Authorized official

Name
Mr. Herbert Kendrick III, QP, MBA
Title
Director
Phone
(704) 395-9387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NC Primary

Addresses

Primary practice location

3828 Cobbleridge Drive
Charlotte, NC 28215

Mailing address

PO Box 668882
Charlotte, NC 28266-8882
Phone (704) 395-9387

Other identifiers 1

IdentifierTypeStateIssuer
3409000MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Special K Enrichment Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1114346889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668882",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282668882",
            "telephone_number": "704-395-9387",
            "fax_number": "704-395-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 COBBLERIDGE DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-395-3987",
            "fax_number": "704-395-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL K ENRICHMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-395-9387",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "QP, MBA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409000",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.