Photorealistic Areola & Healing Arts Institute

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Legal business name

PHOTOREALISTIC AREOLA & HEALING ARTS INSTITUTE

Practice address

4058 S Lone Pine Ave
Springfield, MO 65804-6605

Phone

(417) 763-5414

NPI assigned

Jul 9, 2024

Last updated

Oct 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer WilliamsNPI 1174971295

Title

Billing Manager

Phone

(407) 982-4876

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Jennifer June Williams

  • Other Specialist/Technologist
  • Orlando, FL
  • NPI 1174971295
  Authorized official Same address or phone
• Autumn Wind Sharp

  • Other Specialist/Technologist
  • Springfield, MO
  • NPI 1215773494

  Plastic and Reconstructive Surgery

  NPD

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1306683255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4058 S LONE PINE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046605",
            "telephone_number": "417-763-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4058 S LONE PINE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046605",
            "telephone_number": "417-763-5414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Rancho Dr Ste H51",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064836",
            "country_code": "US",
            "telephone_number": "407-982-4876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOTOREALISTIC AREOLA & HEALING ARTS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "407-982-4876"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physicians for Breast Health, L.L.C.
• Cherrie L Pickett, FNP

• Other Specialist/Technologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Other Specialist/Technologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.