Active NPI
Excel Tutoring and Personal Development
- Community/Behavioral Health Agency
- Gastonia, NC
National Provider Identifier
1508986340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- EXCEL TUTORING AND PERSONAL DEVELOPMENT
- Practice address
- 1385 E Garrison Blvd
Gastonia, NC 28054-5127 - Phone
- (704) 854-5225
- Fax
- (704) 854-5205
- NPI assigned
- Mar 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Tillman
- Title
- President
- Phone
- (704) 635-7766
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1385 E Garrison Blvd
Gastonia, NC 28054-5127
Mailing address
1502 N Charlotte Ave
Monroe, NC 28110-2500
Phone (704) 635-7766
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3418207 | Medicaid | NC | |
| 8300848 | Medicaid | NC |
Other names 1
- Excel Personal Development
National Provider Directory
National Provider Directory- Tax ID family
- Excel Personal Development
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-
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- Community/Behavioral Health Agency
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1230508800000",
"number": "1508986340",
"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": "1385 E GARRISON BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545127",
"telephone_number": "704-854-5225",
"fax_number": "704-854-5205"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXCEL TUTORING AND PERSONAL DEVELOPMENT",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-29",
"last_updated": "2008-12-29",
"status": "A",
"authorized_official_last_name": "TILLMAN",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "704-635-7766",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"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": "3418207",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8300848",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Excel Personal Development",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gastonia, 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.