NPIMap

Organization Active NPI

Custom Hair Extensions & Hair Loss Center

  • Prosthetics Case Management
  • Tucker, GA
National Provider Identifier
1295101608
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Legal business name
CUSTOM HAIR EXTENSIONS & HAIR LOSS CENTER
Practice address
3983 Lavista Rd
Suite 164
Tucker, GA 30084-5153
Phone
(678) 754-3196
NPI assigned
Aug 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Charla Jones
Title
Certified Hair Loss Specialist
Phone
(678) 754-3196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X Primary

Addresses

Primary practice location

3983 Lavista Rd
Suite 164
Tucker, GA 30084-5153

Mailing address

1900 Glenn Club Dr
Apt 1312
Stone Mountain, GA 30087-3499
Phone (678) 754-3196

National Provider Directory

National Provider Directory

Locations

3983 Lavista Rd
Ste 164
Tucker, GA 30084
Phone (404) 861-0807

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1295101608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GLENN CLUB DR",
            "address_2": "APT 1312",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873499",
            "telephone_number": "678-754-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3983 LAVISTA RD",
            "address_2": "SUITE 164",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845153",
            "telephone_number": "678-754-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM HAIR EXTENSIONS & HAIR LOSS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CHARLA",
        "authorized_official_title_or_position": "CERTIFIED HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "678-754-3196"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

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