Pure Gold Luxz Hair Beauty Luxury

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

PURE GOLD LUXZ HAIR BEAUTY LUXURY

Practice address

508 Owen Dr
Fayetteville, NC 28304-3417

Phone

(910) 479-6214

NPI assigned

Apr 30, 2019

Organization subpart

No

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

Authorized official

Name

Fatia Russell, CERTIFIED HAIR LOSSNPI 1356843379

Title

Owner

Phone

(201) 892-2678

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fatia A Russell

  • Prosthetist
  • Fayetteville, NC
  • NPI 1356843379

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567209600000",
    "number": "1306400759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 LAKEHAVEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040610",
            "telephone_number": "201-892-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043417",
            "telephone_number": "910-479-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE GOLD LUXZ HAIR BEAUTY LUXURY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-08-31",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "FATIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-892-2678",
        "authorized_official_credential": "CERTIFIED HAIR LOSS"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356843379",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Www.puregoldluxzhbl.gold",
            "affiliation": "N",
            "endpointDescription": "Pure Gold Luxz hair beauty luxury",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Durable services",
            "address_1": "508 Owen Dr",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hester Purcell, LCSW
• Kornelia Wall Purcell, LCAS-A
• Albert Purdie
• Deja Purdie
• Tamisha Monique Purdie, MSW, LCSWA, LCAS-A
• Saimadhurima Pureti
• Purple Paws, PLLC
• Purpose Driven Support Services LLC
• Ryan Pursley, DO
• Ravi Vishram Purushuttam, M.D.

• Prosthetist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Prosthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2019; 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.