NPIMap

Organization Active NPI

Champion Family Healthcare Services, LLC

  • Home Health Agency
  • Winston Salem, NC
National Provider Identifier
1619288008
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC4124 Issued in NC
Legal business name
CHAMPION FAMILY HEALTHCARE SERVICES, LLC
Practice address
2717 Sawgrass CT
Winston Salem, NC 27103-6691
Phone
(336) 659-2359
Fax
(336) 785-9111
NPI assigned
Jun 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Ms. Antoinette Lois Van-Riel
Title
Executive Director
Phone
(901) 283-4566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC4124 NC Primary

Addresses

Primary practice location

2717 Sawgrass CT
Winston Salem, NC 27103-6691

Mailing address

2717 Sawgrass CT
Winston Salem, NC 27103-6691
Phone (336) 659-2359

National Provider Directory

National Provider Directory
Tax ID family
Champion Family Healthcare Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

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": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1619288008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 SAWGRASS CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036691",
            "telephone_number": "336-659-2359",
            "fax_number": "336-785-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 SAWGRASS CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036691",
            "telephone_number": "336-659-2359",
            "fax_number": "336-785-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION FAMILY HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "VAN-RIEL",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_middle_name": "LOIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-283-4566",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC4124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.