Organization Active NPI

Rebourne Aesthetics & Wellness

  • Family Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1053017806
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
REBOURNE AESTHETICS & WELLNESS
Doing business as
Rebourne Aesthetics & Wellness
Practice address
720 Avignon Dr Ste 2
Ridgeland, MS 39157-5166
Phone
(601) 503-0335
NPI assigned
Feb 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Authorized official

Name
Ms. Larona Searcy, FNPNPI 1053665232
Title
Owner
Phone
(601) 503-0335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

720 Avignon Dr Ste 2
Ridgeland, MS 39157-5166

Mailing address

161 Woodland Dr
Madison, MS 39110-8751
Phone (601) 503-0335

Other names 1

  • Rebourne Aesthetics & Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1053017806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WOODLAND DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108751",
            "telephone_number": "601-503-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 AVIGNON DR STE 2",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575166",
            "telephone_number": "601-503-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOURNE AESTHETICS & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "SEARCY",
        "authorized_official_first_name": "LARONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-503-0335",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebourne Aesthetics & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.