Sommerville Group Services

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

168913 Issued in NC

Legal business name

SOMMERVILLE GROUP SERVICES

Practice address

1017 Woodkirk LN
Matthews, NC 28104-8053

Phone

(704) 219-6084

NPI assigned

Apr 1, 2009

Organization subpart

No

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

Authorized official

Name

Kenneth Asah Fon-Ndikum

Title

Co-Founder

Phone

(704) 219-6084

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1992947154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 WOODKIRK LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281048053",
            "telephone_number": "704-219-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 WOODKIRK LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281048053",
            "telephone_number": "704-219-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMMERVILLE GROUP SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "FON-NDIKUM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ASAH",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "704-219-6084"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "168913",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NC",
            "license": "168913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Matthews, NC
• Providers in Matthews, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.