Essentials Soulon

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ESSENTIALS SOULON

Practice address

2736 Keating St
Temple Hills, MD 20748-1512

Phone

(202) 802-3098

Fax

(301) 836-1772

NPI assigned

Dec 3, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Dejuan Andrea Burns

Title

Owner

Phone

(202) 802-3098

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Essentials Soul-on LLC

  • Prosthetic/Orthotic Supplier
  • Clinton, MD
  • NPI 1154724094
  NPD tax ID

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1174998009",
    "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",
            "fax_number": "301-836-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 KEATING ST",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481512",
            "telephone_number": "202-802-3098",
            "fax_number": "301-836-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIALS SOULON",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "DEJUAN",
        "authorized_official_middle_name": "ANDREA",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1174998009",
            "identifier": "1013275445",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Erica Ewell, CCMA, CMT
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• Prosthetic/Orthotic Supplier in Temple Hills, MD
• Providers in Temple Hills, MD by specialty
• Prosthetic/Orthotic Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.