NPIMap

Organization Active NPI

Exodus Hair & Nail Studio LLC

  • Massage Therapist
  • Saint Clair Shores, MI
National Provider Identifier
1114468428
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
332924-00 Issued in MI
Legal business name
EXODUS HAIR & NAIL STUDIO LLC
Practice address
21526 Harper Ave
Saint Clair Shores, MI 48080-2210
Phone
(586) 242-5729
NPI assigned
Mar 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Mrs. Kandy Wagner, M.T.NPI 1306166723
Title
Owner
Phone
(586) 242-5729

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)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 332924-00 MI Primary

Addresses

Primary practice location

21526 Harper Ave
Saint Clair Shores, MI 48080-2210

Mailing address

21526 Harper Ave
St. Clair Shores, MI 48080
Phone (586) 242-5729

National Provider Directory

National Provider Directory

Locations

21526 Harper Ave
Saint Clair Shores, MI 48080
Phone (586) 242-5729

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": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1114468428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21526 HARPER AVE",
            "city": "ST. CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-242-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21526 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802210",
            "telephone_number": "586-242-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS HAIR & NAIL STUDIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "KANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-242-5729",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "332924-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.