Individual provider Active NPI

Chevon Marverlette Strickland

  • Administrator Registered Nurse
  • Charlotte, NC
National Provider Identifier
1629662168
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
259517 Issued in NC
Practice address
6504 Peacehaven Dr
Charlotte, NC 28214-2300
Phone
(170) 449-3309
NPI assigned
Feb 25, 2021
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 259517 NC Primary

Addresses

Primary practice location

6504 Peacehaven Dr
Charlotte, NC 28214-2300

Mailing address

6504 Peacehaven Dr
Charlotte, NC 28214-2300
Phone (170) 449-3309

Other identifiers 1

IdentifierTypeStateIssuer
86-1954139MedicaidNC

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
259517NCMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
C&S Home Care Agency, L.L.C. Administrator CurrentSince May 16, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1629662168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 PEACEHAVEN DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282142300",
            "telephone_number": "170-449-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6504 PEACEHAVEN DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282142300",
            "telephone_number": "170-449-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRICKLAND",
        "first_name": "CHEVON",
        "middle_name": "MARVERLETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NC",
            "license": "259517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86-1954139",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.