NPIMap

Organization Active NPI

Divine Koncepts, Inc

  • Developmentally Disabled Services Day Training Agency
  • Rockingham, NC
National Provider Identifier
1497857833
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
RES/CAP/CIS Issued in NC
Legal business name
DIVINE KONCEPTS, INC
Practice address
1219 Rockingham Rd
Suite 12
Rockingham, NC 28379-4983
Phone
(910) 417-4950
Fax
(910) 417-4953
NPI assigned
Sep 5, 2006
Last updated
Sep 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Mrs. Brenda T Capel, B.S./QP
Title
President/Ceo
Phone
(910) 417-4950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X RES/CAP/CIS NC Primary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-077-044 NC

Addresses

Primary practice location

1219 Rockingham Rd
Suite 12
Rockingham, NC 28379-4983

Mailing address

PO Box 462
Ellerbe, NC 28338-0462
Phone (910) 417-4950

Other identifiers 3

IdentifierTypeStateIssuer
8300948MedicaidNC
7805610MedicaidNC
3418060MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Divine Koncepts Inc3 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.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1497857833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 462",
            "city": "ELLERBE",
            "state": "NC",
            "postal_code": "283380462",
            "telephone_number": "910-417-4950",
            "fax_number": "910-417-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 ROCKINGHAM RD",
            "address_2": "SUITE 12",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283794983",
            "telephone_number": "910-417-4950",
            "fax_number": "910-417-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE KONCEPTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "CAPEL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "910-417-4950",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S./QP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "RES/CAP/CIS",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-077-044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300948",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805610",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418060",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.