Perfect Balance Boutique

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

Legal business name

PERFECT BALANCE BOUTIQUE

Practice address

813 Fredericks Grove Rd
Lehighton, PA 18235-9661

Phone

(484) 464-3295

NPI assigned

Jul 30, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Nicole Gerhard, CFMNPI 1679050066

Title

Owner

Phone

(484) 464-3295

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Kimberly Nicole Gerhard, CFM

  • Mastectomy Fitter
  • Lehighton, PA
  • NPI 1679050066
  NPD Authorized official

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1114405412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 FREDERICKS GROVE RD",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182359661",
            "telephone_number": "484-464-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FREDERICKS GROVE RD",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182359661",
            "telephone_number": "484-464-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT BALANCE BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "GERHARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-464-3295",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CFM"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mastectomy Fitter",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Outlaw
• Kelsie Pane, PA-C
• Tatyana Pankratova, M.D.
• Jared Paster, DO
• Frank R Penater, MD
• Tanya Lynn Petaccio, CRNP
• Phoenix Rehabilitation and Health Services, Inc.
• Samantha Postupack, M.A. CCC-SLP
• Luke John Price, PA-C
• Eric Michael Pridgen, MD

• Mastectomy Fitter in Lehighton, PA
• Providers in Lehighton, PA by specialty
• Mastectomy Fitter in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.