Renee Mikeasha Paisley-Green, HAIR REPLACEMENT SPC

Primary specialty

SpecialistTaxonomy code 174400000X

License

CO134520 Issued in GA

Practice address

2852 Deans Bridge Rd Ste C
Augusta, GA 30906-2767

Phone

(954) 305-4061

NPI assigned

Nov 24, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1669248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1154031615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 DEANS BRIDGE RD STE C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062767",
            "telephone_number": "954-305-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 DEANS BRIDGE RD STE C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062767",
            "telephone_number": "954-305-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAISLEY-GREEN",
        "first_name": "RENEE",
        "middle_name": "MIKEASHA",
        "credential": "HAIR REPLACEMENT SPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-24",
        "last_updated": "2022-11-24",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "CO134520",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "CO134520",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "CO134520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ONYXNMANE@GMAIL.COM",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "onyxnmane@gmail.com",
            "address_1": "2852 Deans Bridge Rd Ste C",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309062767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ONYXNMANE@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2852 Deans Bridge Rd Ste C",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309062767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Renee T Page, MD
• Vidya B Pai, MD
• Taylor Paige
• Britney Wilkinson Paine, LAPC, M.ED
• Jill Painter
• Jose Andres Palacios
• Anthony J Palazzo, PA-C
• Christopher Pallas, MD
• Allie Howard Palmer
• Clinton James Palmer, M.D.

• Specialist in Augusta, GA
• Providers in Augusta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2022; 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.