Active NPI
Chennetha Ephriam
- Phlebotomy Technician
- Hope Mills, NC
National Provider Identifier
1962819912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- 630331140001
- Practice address
- 3809 Crusader Dr
Hope Mills, NC 28348-9003 - Phone
- (910) 551-5664
- NPI assigned
- Jul 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | 630331140001 | NC | Primary |
Addresses
Primary practice location
3809 Crusader Dr
Hope Mills, NC 28348-9003
Mailing address
3809 Crusader Dr
Hope Mills, NC 28348-9003
Phone (910) 551-5664
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
| License | State | Type | Specialty |
|---|---|---|---|
| 630331140001 | NC | MD | Phlebotomy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blessed Hands Phlebotomy | Phlebotomy | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446163200000",
"number": "1962819912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3809 CRUSADER DR",
"city": "HOPE MILLS",
"state": "NC",
"postal_code": "283489003",
"telephone_number": "910-551-5664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3809 CRUSADER DR",
"city": "HOPE MILLS",
"state": "NC",
"postal_code": "283489003",
"telephone_number": "910-551-5664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EPHRIAM",
"first_name": "CHENNETHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-22",
"last_updated": "2015-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "NC",
"license": "630331140001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hope Mills, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.