Bombshell Aesthetics & Weight Loss Clinic PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

BOMBSHELL AESTHETICS & WEIGHT LOSS CLINIC PLLC

Practice address

197 Otto Dr # 42
Inez, KY 41224-8808

Phone

(606) 229-0072

NPI assigned

May 10, 2024

Last updated

May 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Dawn Spence, APRNNPI 1376026542

Title

Owner/Provider

Phone

(606) 626-7093

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Dawn Spence, APRN

  • Family Nurse Practitioner
  • Inez, KY
  • NPI 1376026542
  NPD Authorized official

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1134977408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 OTTO DR # 42",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412248808",
            "telephone_number": "606-229-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 OTTO DR # 42",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412248808",
            "telephone_number": "606-229-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOMBSHELL AESTHETICS & WEIGHT LOSS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "606-626-7093",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Big Sandy Health Care, Inc (Martin County Community Health Center)
• Big Sandy Health Care, Inc (Inez Elementary School Clinic)
• Big Sandy Health Care, Inc (Martin County High School Clinic)
• Blacklog Apothecary Inc (Medicine Shoppe)
• Ashley Blair
• Donald L Chaffin Jr., M.D.
• Community Alternatives Kentucky
• Consolidated Health Systems (Martin County Community Care Clinic)
• Ronnie Allen Cook, DC
• Catherine Marie Corbett

• Medical Specialty Clinic/Center in Inez, KY
• Providers in Inez, KY by specialty
• Medical Specialty Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.