CORNELIA NIXON DAVIS INC. NPI 1851396535

NPI Information

  • NPI: 1851396535
  • Provider Name: CORNELIA NIXON DAVIS, INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: CHAMPIONS ASSISTED LIVING
  • CLIA Number: 34D1104278
  • Address: 1007 PORTERS NECK RD
    WILMINGTON, NC
    ZIP 28411
  • Phone: (910) 686-6462

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NPI Details

CORNELIA NIXON DAVIS, INC. is an assisted living facility in Wilmington, NC. The provider is 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. CORNELIA NIXON DAVIS, INC. NPI is 1851396535. The provider is registered as an organization entity type.
The provider Is Doing Business As Champions Assisted Living.

The provider's business location address is:

1007 PORTERS NECK RD
WILMINGTON, NC
ZIP 28411-383
Phone: (910) 686-6462
Fax: (910) 686-8320

The provider's authorized official is Charles Allen Long .
The authorized official title is Executive Director and has the following contact phone number (910) 686-7195.

The CLIA number assigned to this NPI record is 34D1104278 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityHAL065020NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17804910MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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