Organization Active NPI

CM Excavating, LLC

  • Home Modifications Contractor
  • Texico, IL
National Provider Identifier
1114763299
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
Legal business name
CM EXCAVATING, LLC
Practice address
12374 E Middle Rd
Texico, IL 62889-3400
Phone
(618) 339-1571
NPI assigned
Jul 8, 2024
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle Prosser
Title
Owner
Phone
(618) 339-1571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications ContractorGroup: 193400000X SINGLE SPECIALTY GROUP 171WH0202X Primary

Addresses

Primary practice location

12374 E Middle Rd
Texico, IL 62889-3400

Mailing address

3669 Metcalf Rd
Iuka, IL 62849-1923
Phone (618) 339-1571

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1114763299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3669 METCALF RD",
            "city": "IUKA",
            "state": "IL",
            "postal_code": "628491923",
            "telephone_number": "618-339-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12374 E MIDDLE RD",
            "city": "TEXICO",
            "state": "IL",
            "postal_code": "628893400",
            "telephone_number": "618-339-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CM EXCAVATING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "PROSSER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-339-1571"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texico, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.