Organization Active NPI

Madame Omega'S Hair & Wellness

  • Specialist
  • Orange Park, FL
National Provider Identifier
1265390249
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MADAME OMEGA'S HAIR & WELLNESS
Practice address
115 Woodside Dr
Orange Park, FL 32073-3319
Phone
(904) 440-8559
NPI assigned
Jan 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Ms. Erica McConnellNPI 1558162628
Title
Hair Loss Specialist
Phone
(904) 440-8559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

115 Woodside Dr
Orange Park, FL 32073-3319

Mailing address

3820 Colebrooke Dr
Jacksonville, FL 32210-5183
Phone (904) 440-8559

National Provider Directory

National Provider Directory

Locations

115 Woodside Dr
Orange Park, FL 32073
Phone (904) 440-8559

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1265390249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 COLEBROOKE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322105183",
            "telephone_number": "904-440-8559",
            "fax_number": "904-440-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WOODSIDE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733319",
            "telephone_number": "904-440-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADAME OMEGA'S HAIR & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "904-440-8559",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; 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.