GENESIS PROJECT 1 (NPI# 1417364480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417364480 |
| Entity Type | Organization |
| Organization Name | GENESIS PROJECT 1 |
| Practice Address |
5108 Reagan Dr Suite 14 Charlotte NC 28206-3103 |
| Practice Telephone | 7045960505 |
| Practice Fax Number | 7045960507 |
| Mailing Telephone | 7045960505 |
| Mailing Fax Number | 7045960507 |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2014-07-22 |
| Authorized Official Name | DR. TRASHA BLACK (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 7045960505 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | P009049 | NC | Managed Care Organizations |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Genesis Project 1, Inc. | 5108 Reagan Drive, Ste. 14, Charlotte, NC 28206 |
| Street Address |
5108 REAGAN DR SUITE 14 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28206-3103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972809903 | Carolina Access Support & Enrichment Services Inc | Physical Therapist | 5108 Reagan Dr, Suite 10, Charlotte, NC 28206-3103 | 2011-02-09 |
| 1255948196 | Marcus Jamar Gaddy | Social Worker | 5108 Reagan Dr, Charlotte, NC 28206-3103 | 2020-09-24 |
| 1336771898 | Sam Hawk | Counselor | 5108 Reagan Dr, Suite 14, Charlotte, NC 28206-1395 | 2020-02-12 |
| 1093213621 | Mishelle L Lockerby | Counselor | 5108 Reagan Dr, Charlotte, NC 28206 | 2018-01-29 |
| 1790295731 | Rebecca Schrenker | Social Worker | 5108 Reagan Dr, Charlotte, NC 28206-3103 | 2017-10-04 |
| 1770030918 | Caroline Watkins | Social Worker | 5108 Reagan Dr, Charlotte, NC 28206-3103 | 2016-09-06 |
| 1447705082 | Alexis Brightman | Psychologist | 5108 Reagan Dr, Suite 14, Charlotte, NC 28206-3103 | 2016-08-24 |
| 1558755116 | Chenita Freeman | Counselor | 5108 Reagan Dr, Suite 14, Charlotte, NC 28206-3103 | 2015-03-22 |
| 1275922593 | Britney Elizabeth Harrington | Counselor | 5108 Reagan Dr, Charlotte, NC 28206-3103 | 2015-01-12 |
| 1235530635 | Clivia Milburn | Counselor | 5108 Reagan Dr, Charlotte, NC 28206-3103 | 2014-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1609433291 | Life Interrupted Counseling Services | Counselor | 4045 N Tryon St Ste A, Charlotte, NC 28206 | 2019-05-20 |
| 1295141216 | Taqiyah Camyah Barber | Prosthetic/Orthotic Supplier | 3829 Perennial Terrace Dr, #g, Charlotte, NC 28206 | 2014-07-10 |
| 1386976033 | Olugboyega Remi Fisher | Community Health Worker | 1801 N.tryon Street, Suiteb114, Charlotte, NC 28206 | 2010-02-05 |
| 1821225699 | Alzenia Kelly Morris | Counselor | 1801 N Tryon Street Ste 339, Charlotte, NC 28206 | 2009-06-18 |
| 1942479936 | American Current Care of North Carolina PC | Clinic/Center | 2835 Jeff Adams Drive, Suite A, Charlotte, NC 28206 | 2008-02-25 |
| 1992823629 | Shari J Baum | Preventive Medicine | 2830 North I-85, Suite A and B, Charlotte, NC 28206 | 2007-03-27 |
| 1255479135 | Tameka Denise Jenkins | Counselor | 1600 Norris Ave., Charlotte, NC 28206 | 2007-02-02 |
| 1871655803 | Dwight Hollier | Counselor | 1801 North Tryon Street, Suite 309, Charlotte, NC 28206 | 2006-12-15 |
| 1487172060 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4220 N Tryon St, Charlotte, NC 28206 | 2017-09-05 |
| Find all providers in zip 28206 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639624034 | Choices for Recovery, LLC | Point of Service | 200 Queens Rd Ste 102, Charlotte, NC 28204-3252 | 2016-08-16 |
| 1144519125 | Purpose of Life | Point of Service | 2601 Palm Ave, Charlotte, NC 28205-2239 | 2011-03-30 |
| 1346391018 | Spelios and Associates Pa Iv | Point of Service | Spelios and Associates Pa Iv, Suite 120, Charlotte, NC 28210 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972126092 | Vax Mobile Nc LLC | Point of Service | 204 Crestmont Ridge Dr, Apex, NC 27523-7119 | 2020-05-22 |
| 1285190926 | Roshonda Mcfadden | Point of Service | 12 Winding Creek Cir Apt P, Durham, NC 27705-1541 | 2019-02-19 |
| 1437640448 | Kevin Lamont Lane | Point of Service | 7149 Jennings Rd Ne, Leland, NC 28451-9431 | 2018-05-24 |
| 1891164869 | Amy Cleckler | Point of Service | 809 North St, Durham, NC 27701-2210 | 2015-09-21 |
| 1760859193 | Triad Health Solutions | Point of Service | 6420 Rains Davis Rd, Kernersville, NC 27284-0127 | 2015-09-02 |
| 1215331525 | Saylor Physical Therapy Cornelius LLC | Point of Service | 19460 Old Jetton Rd, Suite 202, Cornelius, NC 28031-6456 | 2014-10-15 |
| 1316385438 | Lauren M. Grantham | Point of Service | 1807 E Walnut St, Goldsboro, NC 27530-5330 | 2013-06-11 |
| 1184985178 | Kerr Drug | Point of Service | 206 Us Route 117 South, Burgaw, NC 28425 | 2012-06-06 |
| 1467729855 | Bridging The Gap of North Carolina | Point of Service | 3050 Riverwood Pkwy Ste B, Gastonia, NC 28056-6002 | 2011-11-29 |
| 1558638767 | Resource Care Alliance, Inc | Point of Service | 516-d River Highway, Suite 145, Mooresville, NC 28117 | 2011-11-17 |
| Find all providers with the same taxonomy | ||||
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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.