NPIMap

Organization Active NPI

Essentials Soul-on LLC

  • Prosthetic/Orthotic Supplier
  • Clinton, MD
National Provider Identifier
1154724094
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
425560 Issued in MD
Legal business name
ESSENTIALS SOUL-ON LLC
Practice address
7902 Old Branch Ave
105
Clinton, MD 20735-1646
Phone
(202) 802-3098
NPI assigned
Oct 7, 2014
Last updated
Oct 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Authorized official

Name
Ms. Dejuan BurnsNPI 1013275445
Title
Owner
Phone
(202) 802-3098

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 425560 MD Primary

Addresses

Primary practice location

7902 Old Branch Ave
105
Clinton, MD 20735-1646

Mailing address

6600 Horseshoe Rd
Clinton, MD 20735-2537
Phone (202) 802-3098

National Provider Directory

National Provider Directory
Tax ID family
Essentials Soul-on LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7902 Old Branch Ave
Ste 105
Clinton, MD 20735
Phone (202) 795-5444

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1154724094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 HORSESHOE RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352537",
            "telephone_number": "202-802-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7902 OLD BRANCH AVE",
            "address_2": "105",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351646",
            "telephone_number": "202-802-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIALS SOUL-ON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "DEJUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-802-3098",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MD",
            "license": "425560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.