Indigenous Health Alliance LLC

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

INDIGENOUS HEALTH ALLIANCE LLC

Doing business as

Indigenous Health Alliance

Practice address

3310 N Davidson St Apt 365
Charlotte, NC 28205-1284

Phone

(704) 657-0689

NPI assigned

May 9, 2023

Organization subpart

No

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

Authorized official

Name

Chief Patrick Stone, MEDICAL MISSIONARY

Title

Managing Member

Phone

(240) 573-4148

Specialties & licenses 1

Addresses

Other names 1

• INDIGENOUS HEALTH ALLIANCE Doing business as

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1518657006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 N DAVIDSON ST APT 365",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051284",
            "telephone_number": "704-657-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 N DAVIDSON ST APT 365",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051284",
            "telephone_number": "704-657-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGENOUS HEALTH ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "CHIEF",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "240-573-4148",
        "authorized_official_credential": "MEDICAL MISSIONARY"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDIGENOUS HEALTH ALLIANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Supports Brokerage Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Supports Brokerage Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.