CCM Champaign County Mobility LL

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CCM CHAMPAIGN COUNTY MOBILITY LL

Practice address

1508 W Anthony Dr
Champaign, IL 61821-1191

Phone

(217) 359-5800

Fax

(217) 398-8901

NPI assigned

Dec 16, 2019

Organization subpart

No

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

Authorized official

Name

John Michael BeckwithNPI 1386157618

Title

Owner

Phone

(217) 359-5800

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Michael Beckwith

  • Home Modifications Contractor
  • Champaign, IL
  • NPI 1386157618
  NPD (past) Authorized official

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1912545310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 W ANTHONY DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618211191",
            "telephone_number": "217-359-5800",
            "fax_number": "217-398-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 W ANTHONY DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618211191",
            "telephone_number": "217-359-5800",
            "fax_number": "217-398-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCM CHAMPAIGN COUNTY MOBILITY LL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "BECKWITH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-359-5800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnbeckwith@ccmobility.com",
            "affiliation": "N",
            "address_1": "1508 W Anthony Dr",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618211191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Champaign, IL
• Providers in Champaign, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.