Champion Supports & Services, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CHAMPION SUPPORTS & SERVICES, INC

Practice address

3409 N Mayo TRL
Pikeville, KY 41501-3268

Phone

(606) 432-8666

Fax

(606) 432-8159

NPI assigned

Jan 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tonya Dee Newsome-Sanders

Title

Executive Director & President

Phone

(606) 432-8666

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386795268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 N MAYO TRL",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013268",
            "telephone_number": "606-432-8666",
            "fax_number": "606-432-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N MAYO TRL",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013268",
            "telephone_number": "606-432-8666",
            "fax_number": "606-432-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION SUPPORTS & SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWSOME-SANDERS",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR & PRESIDENT",
        "authorized_official_telephone_number": "606-432-8666"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33000779",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stacy Michelle Chaffins
• Champion Supports & Community Services, Inc
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• Pernella Rae Chapman, RBT
• Rhonda Melissa Charles
• Shylebra Lea Charles, APRN

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.