Community Impact Alliance

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

COMMUNITY IMPACT ALLIANCE

Practice address

2266 N Roan St
Johnson City, TN 37601-2527

Phone

(423) 262-0180

Fax

(423) 262-0181

NPI assigned

Aug 18, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Carrie Davis Marchant

Title

Partner

Phone

(423) 262-0180

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1811202500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012527",
            "telephone_number": "423-262-0180",
            "fax_number": "423-262-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012527",
            "telephone_number": "423-262-0180",
            "fax_number": "423-262-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY IMPACT ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "MARCHANT",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "423-262-0180",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.