CORNELIA NIXON DAVIS, INC. (NPI# 1851396535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851396535 |
| Entity Type | Organization |
| Organization Name | CORNELIA NIXON DAVIS, INC. |
| Other Organization Name | CHAMPIONS ASSISTED LIVING |
| Practice Address |
1007 Porters Neck Rd Wilmington NC 28411-7383 |
| Practice Telephone | 9106866462 |
| Practice Fax Number | 9106868320 |
| Mailing Telephone | 9106866462 |
| Mailing Fax Number | 9106868320 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CHARLES ALLEN LONG (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9106867195 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | HAL065020 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804910 | 05 |
| Other Name | Type Code |
|---|---|
| Champions Assisted Living | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841697422 | Cornelia Nixon Davis, Inc. | Skilled Nursing Facility | 83 Cavalier Dr., 200, Wilmington, NC 28405-4444 | 2014-11-26 |
| 1356346191 | Cornelia Nixon Davis, Inc. | Clinic/Center | 1011 Porters Neck Rd, Wilmington, NC 28411-9196 | 2005-06-17 |
| 1235598772 | Cornelia Nixon Davis, Inc. | In Home Supportive Care | 1013 Porters Neck Rd, Suite 130, Wilmington, NC 28411-8130 | 2016-02-12 |
| 1972735330 | Cornelia Nixon Davis, Inc. | Internal Medicine | 1013 Porters Neck Rd Ste 100, Wilmington, NC 28411-9196 | 2009-08-19 |
| Street Address |
1007 PORTERS NECK RD |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28411-7383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487188439 | Monica Petrella | Physical Therapy Assistant | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2017-04-17 |
| 1497158117 | Lauren Elizabeth Spinks Radkowski | Physical Therapist | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2014-10-08 |
| 1730438029 | Cindi Semken | Physical Therapy Assistant | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2012-09-03 |
| 1730317694 | Lania D'amore Kelly | Occupational Therapist | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2009-06-30 |
| 1255575676 | Julie A Mistovich | Physical Therapy Assistant | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2009-04-29 |
| 1528214251 | Julia A Sullivan | Physical Therapist | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2008-08-13 |
| 1871706853 | M. Celeste Mcconnell | Occupational Therapist | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2007-05-07 |
| 1700904026 | Gwendolyn Lee Hufham | Occupational Therapy Assistant | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2007-03-26 |
| 1306962287 | Tisha Jones | Speech-Language Pathologist | 1007 Porters Neck Rd, Wilmington, NC 28411-7383 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447744941 | Mercedes Wilkins Mclaughlin | Social Worker | 7008 Cape Harbor Dr Apt A, Wilmington, NC 28411 | 2018-06-18 |
| 1619480811 | Physical Therapy Services of Wilmington At Porter's Neck, LLC | Physical Therapist | 167 Porters Neck Road, Suite D, Suite D, Wilmington, NC 28411 | 2017-11-09 |
| 1578954970 | Erin Fitzpatrick Vasquez | Physical Therapist | 441 Biscayne Dr., Wilmington, NC 28411 | 2015-02-07 |
| 1679961932 | Sheena Cannady | Occupational Therapy Assistant | 7205 Savanna Run Loop, Wilmington, NC 28411 | 2015-01-08 |
| 1548510753 | Lindsey Tarrant Pediatric Speech Pathology Services | Speech-Language Pathologist | 7842 Olde Pond Rd, Wilmington, NC 28411 | 2012-09-14 |
| 1912224601 | Michele Ann Hardee | Physical Therapy Assistant | 1011 Porters Neck Road, Wilmington, NC 28411 | 2010-04-21 |
| 1629216577 | Plantation Village | In Home Supportive Care | 1200 Porters Neck Rd, Wilmington, NC 28411 | 2009-01-30 |
| 1467606095 | Dana B. Shumate Dds, Pa | Dentist | 8131 Market St, Wilmington, NC 28411 | 2008-11-10 |
| 1427212745 | Malgorzata Maria Betkowski | Counselor | 8044 Market Street, Suite D, Wilmington, NC 28411 | 2008-07-16 |
| 1366625014 | The Lawson's House | Day Training, Developmentally Disabled Services | 6622 F Gordan Rd, Wilmington, NC 28411 | 2007-12-17 |
| Find all providers in zip 28411 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073160156 | Snh Del Tenant LLC | Assisted Living Facility | 1912 Marsh Road, Wilmington, DE 19810-3900 | 2019-08-22 |
| 1619445483 | Harborchase of Wilmington, LLC | Assisted Living Facility | 2004 Shipley Rd, Wilmington, DE 19803-5248 | 2018-11-09 |
| 1316370208 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 3501 Converse Dr, Wilmington, NC 28403-6179 | 2013-08-14 |
| 1437426624 | Weatherly B Landry | Assisted Living Facility | 2029 Burnett Blvd, Wilmington, NC 28401-6939 | 2011-11-16 |
| 1972889715 | New Hanover House, LLC | Assisted Living Facility | 3915 Stedwick Court, Wilmington, NC 28412 | 2011-10-25 |
| 1457651309 | Evergreen Behavioral Management, Inc. | Assisted Living Facility | 46 S Cardinal Dr, Wilmington, NC 28403-1843 | 2010-10-26 |
| 1780831586 | Arden Courts of Wilmington De LLC | Assisted Living Facility | 700 1/2 Foulk Rd, Wilmington, DE 19803-3708 | 2008-08-22 |
| 1770743510 | Lutheran Senior Services | Assisted Living Facility | 1420 N Franklin St, Wilmington, DE 19806-3178 | 2008-06-16 |
| 1285801233 | Ohio Living Communities | Assisted Living Facility | 175 Cape May Dr, Wilmington, OH 45177-2065 | 2008-05-09 |
| 1902020399 | Sunrise Assisted Living of Wilmington | Assisted Living Facility | 2215 Shipley Rd, Wilmington, DE 19803-2305 | 2007-04-13 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28411 |
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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.