Salt & Light Aesthetics Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SALT & LIGHT AESTHETICS INC

Practice address

222 Bell LN Ste 3
West Monroe, LA 71291-6303

Phone

(318) 310-5840

Fax

(318) 319-2024

NPI assigned

Aug 26, 2022

Organization subpart

No

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

Authorized official

Name

Lacey Duncan, FNPNPI 1891290490

Title

Owner

Phone

(318) 310-5840

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Salt & Light Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

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

• Lacey Duncan, FNP

  • Family Nurse Practitioner
  • West Monroe, LA
  • NPI 1891290490
  Medicare reassignment NPD Authorized official
• Katharin Luther Lindsey, FNP

  • Family Nurse Practitioner
  • West Monroe, LA
  • NPI 1215451653
  Medicare reassignment NPD

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1134848583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2382",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712942382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BELL LN STE 3",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712916303",
            "telephone_number": "318-310-5840",
            "fax_number": "318-319-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT & LIGHT AESTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-310-5840",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2608801",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt & Light Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Salt & Light Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Shane Russell, DC
• Edward Hampton Rutland, M.D.
• Roger Wayne Rutledge, FNP
• Stacy Rutledge, FNP-C
• Lyndall Saadat, M.D.
• Christopher H Salter, M.A.,LAC
• Samer N Roy MD LLC
• Samer N Roy, MD LLC
• Samer N. Roy MD LLC
• Crystal Prince Sanches, APRN

• Family Medicine Physician in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.