NPIMap

Organization Active NPI

Sunpath LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1336405034
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-060-1121 Issued in NC
Legal business name
SUNPATH LLC
Practice address
11145 Metromont Pkwy
Charlotte, NC 28269-7510
Phone
(704) 597-0021
NPI assigned
Apr 6, 2012
Last updated
May 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Authorized official

Name
Mrs. Rhonda Wirth, BA,QMHP
Title
Executive Director
Phone
(704) 597-0021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-060-1121 NC Primary

Addresses

Primary practice location

11145 Metromont Pkwy
Charlotte, NC 28269-7510

Mailing address

11145 Metromont Pkwy
Charlotte, NC 28269-7510
Phone (704) 597-0021

Other identifiers 2

IdentifierTypeStateIssuer
8300197MedicaidNC
8300197SMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sunpath LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

11145 Metromont Pkwy
Charlotte, NC 28269
Phone (704) 597-0021

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1336405034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11145 METROMONT PKWY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697510",
            "telephone_number": "704-597-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11145 METROMONT PKWY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697510",
            "telephone_number": "704-597-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNPATH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "WIRTH",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-597-0021",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA,QMHP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-060-1121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300197",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300197S",
            "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 May 21, 2012; 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.