Individual provider Active NPI

Cordelia Challenger

  • Non-emergency Medical Transport (VAN)
  • Fayetteville, NC
National Provider Identifier
1619685864
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
000003720334 Issued in NC
Practice address
311 Gillespie St
Fayetteville, NC 28301-5647
Phone
(910) 973-1956
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 000003720334 NC Primary

Addresses

Primary practice location

311 Gillespie St
Fayetteville, NC 28301-5647

Mailing address

2040 Elvira St Apt 115
Fayetteville, NC 28303-4802
Phone (910) 973-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000003720334NCMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Widow'S Mite Non-Emergency Transportation Non-Emergency Medical Transport (Van) CurrentSince Nov 20, 2022 Accepting new patients

Locations

311 Gillespie St
Fayetteville, NC 28301
Phone (910) 973-1956

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1619685864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 ELVIRA ST APT 115",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034802",
            "telephone_number": "910-973-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 GILLESPIE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015647",
            "telephone_number": "910-973-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALLENGER",
        "first_name": "CORDELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NC",
            "license": "000003720334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.