NPIMap

Organization Active NPI

Angelic Community &and Family Services

  • Preferred Provider Organization
  • Charlotte, NC
National Provider Identifier
1134328636
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
ANGELIC COMMUNITY &AND FAMILY SERVICES
Practice address
5601 Executive Center Dr
Suite 220
Charlotte, NC 28212-8863
Phone
(866) 391-6369
Fax
(866) 293-6371
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Eric Mitchell
Title
Director of Operations
Phone
(704) 532-6369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

5601 Executive Center Dr
Suite 220
Charlotte, NC 28212-8863

Mailing address

5601 Executive Center Dr
Suite 220
Charlotte, NC 28212-8863
Phone (866) 391-6369

Other identifiers 2

IdentifierTypeStateIssuer
8301884BMedicaidNC
8301885BMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Angelic Community and Family Services2 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.

Locations

5601 Executive Center Dr
Ste 220
Charlotte, NC 28212
Phone (704) 532-6369

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1134328636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128863",
            "telephone_number": "866-391-6369",
            "fax_number": "866-293-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128863",
            "telephone_number": "866-391-6369",
            "fax_number": "866-293-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC COMMUNITY &AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "704-532-6369"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301884B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301885B",
            "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 Jul 13, 2007; 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.