Phoenix Residential Care

Primary specialty

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

Legal business name

PHOENIX RESIDENTIAL CARE

Practice address

5003 Hwy 74 East
Wingate, NC 28174

Phone

(704) 327-4444

NPI assigned

Dec 19, 2024

Last updated

Dec 19, 2024By 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

Ronda S Chambers

Title

Chief Executive Officer

Phone

(704) 254-4145

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1437967700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 E MARSHVILLE BLVD",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281031199",
            "telephone_number": "704-327-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 HWY 74 EAST",
            "city": "WINGATE",
            "state": "NC",
            "postal_code": "28174",
            "telephone_number": "704-327-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-254-4145"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Next Level Consulting Services LLC
• Donald Scott Nuzum, PHARM.D.
• Crawford Orr
• Victoria Elizabeth Panzica, ATC
• McKenna Emily Patrick, ATC
• Alex Plyler, LAT, ATC
• Monique Prebensen, ATC, LAT
• Dasia Shanae Ratliff
• Morgan Elizabeth Rhea
• April Robinson, PHARMD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wingate, NC
• Providers in Wingate, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.