NPIMap

Organization Active NPI

Shekinah Resource Foundation

  • Respite Care Camp
  • Statesville, NC
National Provider Identifier
1396288585
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite Care CampTaxonomy code 385HR2050X
License
27780134 Issued in NC
Legal business name
SHEKINAH RESOURCE FOUNDATION
Practice address
301 S Oakland Ave
Unit 6444
Statesville, NC 28687-0837
Phone
(336) 747-3479
NPI assigned
Nov 21, 2016
Last updated
Nov 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Kevin A. SmithNPI 1881052439
Title
Ceo
Phone
(336) 747-3479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 27780134 NC
Respite Care Camp 385HR2050X 27780134 NC Primary

Addresses

Primary practice location

301 S Oakland Ave
Unit 6444
Statesville, NC 28687-0837

Mailing address

450 W Hanes Mill Rd
222
Winston Salem, NC 27105-9141
Phone (336) 747-3479

National Provider Directory

National Provider Directory
Tax ID family
Shekinah Resource Foundation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1396288585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W HANES MILL RD",
            "address_2": "222",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271059141",
            "telephone_number": "336-747-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S OAKLAND AVE",
            "address_2": "UNIT 6444",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286870837",
            "telephone_number": "336-747-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEKINAH RESOURCE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-747-3479"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "27780134",
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": "NC",
            "license": "27780134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.