Luxe Aesthetics & Wellness, LLC
Organization Active NPI Clinic/Center · Red Bay, AL
NPI 1174417877 · NPPES record last updated Aug 4, 2025
Key facts
- NPI
- 1174417877
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- LUXE AESTHETICS & WELLNESS, LLC
- Practice address
- 221 Hospital Rd
Red Bay, AL 35582-3858 - Phone
- (256) 376-2032
- NPI assigned
- Jun 6, 2025
- Organization subpart
- No
Authorized official
- Name
- Devin Fancher, NP
- Title
- Owner/Nurse Practitioner
- Phone
- (256) 376-2032
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2336246 | Luxe Aesthetics & Wellness | Certificate of waiver | Dec 28, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250801002540 | AL | Part B Supplier - Clinic/Group Practice | 2860900727 |
Receives reassigned benefits from 1 practitioner Practice locations: Red Bay, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
221 Hospital Rd
Red Bay, AL 35582-3858
Mailing address
711 Newell Rd
Red Bay, AL 35582-3502
Other providers in Red Bay, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.