Stately Construction LLC

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Legal business name

STATELY CONSTRUCTION LLC

Practice address

504 W High St
Pendleton, IN 46064-1128

Phone

(317) 506-0337

Fax

(765) 778-3658

NPI assigned

Nov 13, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Clinton J Derolf

Title

Partner

Phone

(317) 506-0337

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1740517671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W HIGH ST",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460641128",
            "telephone_number": "317-506-0337",
            "fax_number": "765-778-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W HIGH ST",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460641128",
            "telephone_number": "317-506-0337",
            "fax_number": "765-778-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATELY CONSTRUCTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "DEROLF",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "317-506-0337",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.