Northdavidson a United Methodist Congregation

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

NORTHDAVIDSON A UNITED METHODIST CONGREGATION

Practice address

1025 E 36TH St
Charlotte, NC 28205-1652

Phone

(704) 806-3803

NPI assigned

Oct 18, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Emmanuel Shanka Morris Sr., DOCTOR OF DIVINITY

Title

Lead Pastor

Phone

(704) 806-3803

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1790448629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WINTERFIELD PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055940",
            "telephone_number": "704-806-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 E 36TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051652",
            "telephone_number": "704-806-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHDAVIDSON A UNITED METHODIST CONGREGATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "SHANKA",
        "authorized_official_title_or_position": "LEAD PASTOR",
        "authorized_official_telephone_number": "704-806-3803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DOCTOR OF DIVINITY"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "34D2236552",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Voluntary or Charitable Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Voluntary or Charitable Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.