My Peace Keeper Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MY PEACE KEEPER INC

Practice address

7504 E Independence Blvd Ste 101
Charlotte, NC 28227-9407

Phone

(704) 531-5656

Fax

(704) 531-9711

NPI assigned

Dec 21, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Virginia B Pough, BA

Title

Executive Director

Phone

(704) 531-5656

Specialties & licenses 2

Addresses

Tax ID family

My Peace Keeper 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.

• My Peace Keeper Inc.

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1366592198
  NPD tax ID
• My Peace Keeper Inc

  • Clinic/Center
  • Indian Land, SC
  • NPI 1215314471
  NPD tax ID

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1679802631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7504 E INDEPENDENCE BLVD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282279407",
            "telephone_number": "704-531-5656",
            "fax_number": "704-531-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 E INDEPENDENCE BLVD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282279407",
            "telephone_number": "704-531-5656",
            "fax_number": "704-531-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PEACE KEEPER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "POUGH",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-531-5656",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• My Pediatric Doctor, LLC
• My Positive Transformation
• My RDN Coach, LLC
• My Transport Care, LLC.

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.