MY PEACE KEEPER INC (NPI# 1679802631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679802631 |
| Entity Type | Organization |
| Organization Name | MY PEACE KEEPER INC |
| Practice Address |
7504 E Independence Blvd Ste 101 Charlotte NC 28227-9407 |
| Practice Telephone | 7045315656 |
| Practice Fax Number | 7045319711 |
| Mailing Telephone | 7045315656 |
| Mailing Fax Number | 7045319711 |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2009-12-21 |
| Authorized Official Name | MRS. VIRGINIA B POUGH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7045315656 |
| Authorized Official Credential | BA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364SP0810X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215314471 | My Peace Keeper Inc | Case Management | 3056 Hawick Ln, Indian Land, SC 29707-7780 | 2015-04-27 |
| Street Address |
7504 E INDEPENDENCE BLVD STE 101 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28227-9407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396693 | Phyllis Newsome Wilson | Technician | 8423 Empress Ct, Charlotte, NC 28227 | 2019-09-27 |
| 1134611239 | Alyssa Latonia Rodgers | Counselor | 7512 Spring Spruce Ln, Charlotte, NC 28227 | 2018-06-04 |
| 1114463429 | Andrea Henneberry | Physical Therapy Assistant | 9706 Stoney Glen Dr Apt L, Mint Hill, NC 28227 | 2017-01-10 |
| 1649726589 | Keba Bosley | Social Worker | 5912 Brightstar Valley Road, Mint Hill, NC 28227 | 2016-08-31 |
| 1710330071 | Carolina Family Services | Community/Behavioral Health | 5737 Old Magnolia Lane, Mint Hill, NC 28227 | 2016-07-21 |
| 1518311901 | Aynsley Girardeau | Optometrist | 7014 Tutor Street, Suite C, Mint Hill, NC 28227 | 2016-04-21 |
| 1487037875 | Shalini Kamodia | Dentist | 11300 Cresthill Dr Ste 105, Mint Hill, NC 28227 | 2015-07-02 |
| 1629455720 | Yes We Care Human Services of Mecklenburg County | Adult Companion | 8201 Willowlake Ct, Charlotte, NC 28227 | 2015-04-28 |
| 1841677077 | Hewitt Home Care | Psychiatric Residential Treatment Facility | 2331 Crownpoint Executive Drive, Charlotte, NC 28227 | 2015-04-27 |
| 1467847426 | Marguerita Sitrin Blaker | Psychologist | 2400 Crownpoint Executive Drive, Suite 100, Office #5, Charlotte, NC 28227 | 2015-04-06 |
| Find all providers in zip 28227 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900268 | Jennifer Marie Wolfe | Nurse Practitioner | 831 E Morehead St Ste 900, Charlotte, NC 28202-2726 | 2020-10-19 |
| 1992312433 | Jean L. Caroline Clippard | Nurse Practitioner | 7149 Wessynton Dr, Charlotte, NC 28226-7548 | 2020-09-29 |
| 1790393676 | Alana Weldon | Nurse Practitioner | 10042 Park Cedar Dr, Charlotte, NC 28210-8916 | 2020-07-16 |
| 1114541455 | Kendra Jackson | Nurse Practitioner | 2809 Coltsgate Rd Ste 100, Charlotte, NC 28211-5583 | 2020-06-02 |
| 1740809599 | Nina Cherry Arnold | Nurse Practitioner | 8914 Cotton Press Rd, Charlotte, NC 28277-6676 | 2020-04-13 |
| 1619509197 | Clinica San Antonio Pllc | Nurse Practitioner | 416 Mccullough Dr Ste 110, Charlotte, NC 28262-4387 | 2020-02-12 |
| 1720626773 | Grace Barrosa Genetiano | Nurse Practitioner | 2503 Roswell Ave Unit 507, Charlotte, NC 28209-1685 | 2019-12-19 |
| 1376181081 | Crystal Delgado Calayag Frantilla | Nurse Practitioner | 4206 Craig Ave, Charlotte, NC 28211-3110 | 2019-12-12 |
| 1962059428 | Jerome Virgil Whitlow II | Nurse Practitioner | 6523 Dillard Ridge Dr, Charlotte, NC 28216-8845 | 2019-08-20 |
| 1053978213 | Katie Lynn Sass | Nurse Practitioner | 7004 Smith Corners Blvd Ste A, Charlotte, NC 28269-3827 | 2019-05-23 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.