Organization Active NPI

Divine Nurse Consultant LLC

  • In Home Supportive Care Agency
  • Charlotte, NC
National Provider Identifier
1114567229
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
DIVINE NURSE CONSULTANT LLC
Practice address
5633 Monroe Rd
Charlotte, NC 28212-5591
Phone
(980) 622-8530
NPI assigned
Jan 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Dr. Clifford C Afam
Title
President
Phone
(980) 622-8530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

5633 Monroe Rd
Charlotte, NC 28212-5591

Mailing address

5633 Monroe Rd
Charlotte, NC 28212-5591
Phone (980) 622-8530

Other names 1

  • Divine Home Care Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL URL Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Divine Nurse Consultant LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1114567229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 MONROE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282125591",
            "telephone_number": "980-622-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 MONROE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282125591",
            "telephone_number": "980-622-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE NURSE CONSULTANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "AFAM",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "980-622-8530",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "URL",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5633 Monroe Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282125591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Divine Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Divine Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 8, 2020; 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.