NPIMap

Organization Active NPI

Xtend My Hair Salon & Co LLC

  • Durable Medical Equipment & Medical Supplies
  • Malvern, AR
National Provider Identifier
1093322687
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
XTEND MY HAIR SALON & CO LLC
Practice address
1004 Dyer St
Malvern, AR 72104-5255
Phone
(501) 732-6041
NPI assigned
Sep 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Mr. Terrence Randell Mitchell, HAIR LOSS SPECIALISTNPI 1659907707
Title
Certified Hair Loss Specialist
Phone
(501) 732-6041

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1744P3200X
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

1004 Dyer St
Malvern, AR 72104-5255

Mailing address

327 Woodland St
Malvern, AR 72104-3334
Phone (150) 173-2604

National Provider Directory

National Provider Directory
Tax ID family
Xtend My Hair Salon Co LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the 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": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1093322687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 WOODLAND ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721043334",
            "telephone_number": "150-173-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 DYER ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721045255",
            "telephone_number": "501-732-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XTEND MY HAIR SALON & CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "RANDELL",
        "authorized_official_title_or_position": "CERTIFIED HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "501-732-6041",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "HAIR LOSS SPECIALIST"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.