Perfect Phyzique Wellness & Body Contouring, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PERFECT PHYZIQUE WELLNESS & BODY CONTOURING, LLC

Practice address

220 Carroll St Ste a
Shreveport, LA 71105-4247

Phone

(318) 220-1113

NPI assigned

Apr 27, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Pashala Perry, FNP-C

Title

Nurse Practitioner/Owner

Phone

(214) 329-6161

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588550400000",
    "number": "1205457645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CARROLL ST STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054247",
            "telephone_number": "214-329-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CARROLL ST STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054247",
            "telephone_number": "318-220-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT PHYZIQUE WELLNESS & BODY CONTOURING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "PASHALA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "214-329-6161",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "coputer",
            "affiliation": "N",
            "address_1": "220 Carroll St Ste A",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711054247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jennifer A Perfetto, PT
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• Laura Birdwell Perkins, NP
• Nathaniel Perkins, DPT

• Primary Care Clinic/Center in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.