Second to Nature Boutique, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

600815424 Issued in NC

Legal business name

SECOND TO NATURE BOUTIQUE, LLC

Practice address

4123 Lawndale Dr Ste 101
Greensboro, NC 27455-1887

Phone

(336) 274-2003

Fax

(336) 274-2052

NPI assigned

May 23, 2011

Organization subpart

No

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

Authorized official

Name

Ramona Hertzell, CFMNPI 1821097312

Title

MBR

Phone

(336) 274-2003

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Second to Nature Boutique LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Second to Nature Boutique, LLC

  • Prosthetic/Orthotic Supplier
  • Martinsville, VA
  • NPI 1851635031
  NPD tax ID

Locations

Practitioners 1

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

• Ramona Hertzell, CFM

  • Prosthetics Case Management
  • Greensboro, NC
  • NPI 1821097312
  NPD Authorized official

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1114210218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7968",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274170968",
            "telephone_number": "336-274-2003",
            "fax_number": "336-274-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 LAWNDALE DR STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274551887",
            "telephone_number": "336-274-2003",
            "fax_number": "336-274-2052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 State St",
            "address_2": "Unit A",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274055659",
            "country_code": "US",
            "telephone_number": "336-274-2003",
            "fax_number": "336-274-2052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SECOND TO NATURE BOUTIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "HERTZELL",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "336-274-2003",
        "authorized_official_credential": "CFM"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "600815424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.