Innovative Care Network LLC

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Legal business name

INNOVATIVE CARE NETWORK LLC

Doing business as

Innovative Care Network

Practice address

120 Capcom Ave Ste 102C
Wake Forest, NC 27587-6537

Phone

(215) 279-1509

NPI assigned

Feb 14, 2019

Organization subpart

No

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

Authorized official

Name

Kianna L ChapmanNPI 1831495118

Title

Ceo/Owner

Phone

(215) 279-1509

Specialties & licenses 6

Addresses

Other names 1

• Innovative Care Network Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kianna Lasha' Chapman

  • Behavior Technician
  • Wake Forest, NC
  • NPI 1831495118
  NPD Authorized official

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1780140798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CAPCOM AVE STE 102C",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876537",
            "telephone_number": "215-279-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CAPCOM AVE STE 102C",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876537",
            "telephone_number": "215-279-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE CARE NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "KIANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "215-279-1509"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Care Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innovative Care Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Merci Igwe, PHARMD
• Impeccable Healthcare Services, LLC
• Inclusive Pediatric Therapy
• Margaret L Inman Conrad, PH.D.
• Inner Health Chiropractic, Inc.
• Innovative Therapy and Consulting, Inc
• Instride Foot and Ankle Specialists, PLLC
• Integrity Mental Health and Wellness, PLLC
• Into Words Therapy PLLC
• Intuitive Mental Health Service of North Carolina

• Behavior Technician in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Behavior Technician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.