Kingdom Developmental Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KINGDOM DEVELOPMENTAL SERVICES

Practice address

2109 Saint Andrew St
Suite 12
Tarboro, NC 27886-2149

Phone

(252) 641-6400

Fax

(252) 641-6431

NPI assigned

Sep 20, 2010

Organization subpart

No

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

Authorized official

Name

Vera Davis, RN

Title

President/Ceo

Phone

(252) 641-6400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1306154679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 SAINT ANDREW ST",
            "address_2": "SUITE 12",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862149",
            "telephone_number": "252-641-6400",
            "fax_number": "252-641-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 SAINT ANDREW ST",
            "address_2": "SUITE 12",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862149",
            "telephone_number": "252-641-6400",
            "fax_number": "252-641-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "252-641-6400",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Eugene Kendall Jr., MD
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• Stephen A Kinard, DPM
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• Kimberly B. King, LPTA
• Ashley Marie Kirk, MS, CCC-SLP
• Ann Gielyn Silva-Abueg Konzem, PA-C
• Paul J Krumnacher
• Nancy Lenora Lane, CRNA
• Paul Natale Lanfranchi, PA-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Tarboro, NC
• Providers in Tarboro, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.