NPIMap

Organization Active NPI

Excel Tutoring and Personal Development

Doing business as Excel Personal Development

  • Community/Behavioral Health Agency
  • Concord, NC
National Provider Identifier
1356533343
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXCEL TUTORING AND PERSONAL DEVELOPMENT
Doing business as
Excel Personal Development
Practice address
788 Central Dr
Concord, NC 28027-5032
Phone
(704) 793-1126
Fax
(704) 793-4911
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Authorized official

Name
Mr. John Tillman
Title
President/Ceo
Phone
(704) 635-7766

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

788 Central Dr
Concord, NC 28027-5032

Mailing address

1502 N Charlotte Ave
Monroe, NC 28110-2500
Phone (704) 635-7766

Other identifiers 1

IdentifierTypeStateIssuer
8302144MedicaidNC

Other names 1

  • Excel Personal Development Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excel Personal Development20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

788 Central Dr NW
Concord, NC 28027
Phone (704) 793-1126

1502 N Charlotte Ave
Monroe, NC 28110
Phone (704) 282-0638

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1356533343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N CHARLOTTE AVE",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102500",
            "telephone_number": "704-635-7766",
            "fax_number": "704-635-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 CENTRAL DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280275032",
            "telephone_number": "704-793-1126",
            "fax_number": "704-793-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL TUTORING AND PERSONAL DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "704-635-7766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302144",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Personal Development",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.