Organization Active NPI

Clear Dimensions, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Wilmington, NC
National Provider Identifier
1962949081
Registry record updated Jan 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
CLEAR DIMENSIONS, LLC
Practice address
4607 Tiverton Way Apt 202
Wilmington, NC 28405-6540
Phone
(910) 538-1096
NPI assigned
Jan 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2017

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

Authorized official

Name
Ms. Yushonda Eileen Midgette, BAQP,QDDP,QMHP
Title
Owner/Representative
Phone
(910) 538-1096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

4607 Tiverton Way Apt 202
Wilmington, NC 28405-6540

Mailing address

4607 Tiverton Way Apt 202
Wilmington, NC 28405-6540
Phone (910) 538-1096

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485561600000",
    "number": "1962949081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 TIVERTON WAY APT 202",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284056540",
            "telephone_number": "910-538-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 TIVERTON WAY APT 202",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284056540",
            "telephone_number": "910-538-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR DIMENSIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-28",
        "status": "A",
        "authorized_official_last_name": "MIDGETTE",
        "authorized_official_first_name": "YUSHONDA",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER/REPRESENTATIVE",
        "authorized_official_telephone_number": "910-538-1096",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BAQP,QDDP,QMHP"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2017; 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.