Active NPI
Rebourne Aesthetics & Wellness
- Family Nurse Practitioner
- Ridgeland, MS
National Provider Identifier
1053017806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Larona Searcy, FNP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Primary Care Nurse Practitioner
- Ridgeland, MS
- NPI 1053665232
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.