MEDICARE: NIMON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1366385502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIMON

Provider Business Mailing Address
First Line	:	1635 PORTER BRANCH DR APT 208
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-8531
Country	:	US
Telephone Number	:	404-664-0642
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 PORTER BRANCH DR APT 208
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-8531
Country	:	US
Telephone Number	:	404-664-0642
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NIJIA NICOLE HOPKINS
Credential	:
Telephone Number	:	404-664-0642

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “NIMON ” Practice Location

Language	Start Address	Practice Location

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