Elegant Profile LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ELEGANT PROFILE LLC

Practice address

4622 Country Club Rd Ste 100
Winston Salem, NC 27104-3770

Phone

(336) 331-3480

Fax

(336) 793-1218

NPI assigned

Jan 17, 2024

Organization subpart

No

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

Authorized official

Name

Justine JuchterNPI 1922802255

Title

Vice President

Phone

(336) 331-3480

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justine Juchter

  • Mastectomy Fitter
  • Winston Salem, NC
  • NPI 1922802255
  NPD Authorized official
• Katherine R Stanley, CFM

  • Orthotic Fitter
  • Winston Salem, NC
  • NPI 1164488755

  Mastectomy Fitter

  NPD

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1194586115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 COUNTRY CLUB RD STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043770",
            "telephone_number": "336-331-3480",
            "fax_number": "336-793-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 COUNTRY CLUB RD STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043770",
            "telephone_number": "336-331-3480",
            "fax_number": "336-793-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEGANT PROFILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "JUCHTER",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-331-3480"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mastectomy Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nada K El Husseini, MD
• Elbj Inc
• Alexis Elder
• Samantha Tatum Elder
• Sydney Louise Elder, LCMHCA
• Elevate Counseling & Wellness, PLLC
• Elevated Family Services, LLC
• Elevation Counseling Services PLLC
• Chelsea Elizabeth Eley, LCSWA
• Elite Healthcare Group Inc.

• Durable Medical Equipment & Medical Supplies in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.