NPIMap

Organization Active NPI

Ian Bradley Hair Salon LLC

  • Prosthetic/Orthotic Supplier
  • Macon, GA
National Provider Identifier
1073239265
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
IAN BRADLEY HAIR SALON LLC
Practice address
3902 Northside Dr Ste A3
Macon, GA 31210-2459
Phone
(478) 845-1210
Fax
(478) 210-5078
NPI assigned
Oct 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Melissa R McCoy
Title
Owner
Phone
(478) 714-4302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

3902 Northside Dr Ste A3
Macon, GA 31210-2459

Mailing address

222 Joycliff Cir
Macon, GA 31211-7040
Phone (478) 714-4302

National Provider Directory

National Provider Directory
Tax ID family
Ian Bradley Hair Salon LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1073239265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 JOYCLIFF CIR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312117040",
            "telephone_number": "478-714-4302",
            "fax_number": "478-210-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 NORTHSIDE DR STE A3",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102459",
            "telephone_number": "478-845-1210",
            "fax_number": "478-210-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN BRADLEY HAIR SALON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-714-4302"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.