Tevon Jerell Colbert

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

7352 S NC Highway 18
Boomer, NC 28606-9126

Phone

(828) 850-0619

NPI assigned

Jan 30, 2020

Last updated

Jan 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1194356998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7352 S NC HIGHWAY 18",
            "city": "BOOMER",
            "state": "NC",
            "postal_code": "286069126",
            "telephone_number": "828-850-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7352 S NC HIGHWAY 18",
            "city": "BOOMER",
            "state": "NC",
            "postal_code": "286069126",
            "telephone_number": "828-850-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "TEVON",
        "middle_name": "JERELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "84-4511751",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Lenoir",
            "affiliation": "N",
            "address_1": "523 Arlington Cir NW",
            "city": "Lenoir",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286454208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Boomer, NC
• Providers in Boomer, NC by specialty
• Non-emergency Medical Transport (VAN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.