NPIMap

Organization Active NPI

Sculpted Bodies by Destani LLC.

  • Point of Service
  • Hartsville, SC
National Provider Identifier
1154074730
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
SCULPTED BODIES BY DESTANI LLC.
Practice address
2205 Ousleydale Rd
Hartsville, SC 29550-8733
Phone
(843) 260-9062
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Authorized official

Name
Destynie JordanNPI 1013660125
Title
Owner
Phone
(843) 260-9062

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
Point of Service 305S00000X Primary

Addresses

Primary practice location

2205 Ousleydale Rd
Hartsville, SC 29550-8733

Mailing address

2205 Ousleydale Rd
Hartsville, SC 29550-8733
Phone (843) 260-9062

National Provider Directory

National Provider Directory

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": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1154074730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 OUSLEYDALE RD",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295508733",
            "telephone_number": "843-260-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 OUSLEYDALE RD",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295508733",
            "telephone_number": "843-260-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCULPTED BODIES BY DESTANI LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DESTYNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-260-9062"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.