Total Body Aesthetics, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

FB9712840 Issued in FL

Legal business name

TOTAL BODY AESTHETICS, INC.

Practice address

4540 Southside Blvd
Suite 701
Jacksonville, FL 32216-5492

Phone

(904) 472-5563

Fax

(904) 435-4051

NPI assigned

Aug 16, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie K Humphries, L.M.E.NPI 1083929905

Title

Owner/President

Phone

(904) 472-5563

Specialties & licenses 1

Addresses

Other names 1

• Total Body Health & Wellness Doing business as

Locations

Practitioners 1

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

• Stephanie K Humphries, L.M.E.

  • Specialist
  • Jacksonville, FL
  • NPI 1083929905
  NPD (past) Authorized official

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1336454263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD",
            "address_2": "SUITE 701",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165492",
            "telephone_number": "904-472-5563",
            "fax_number": "904-435-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD",
            "address_2": "SUITE 701",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165492",
            "telephone_number": "904-472-5563",
            "fax_number": "904-435-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL BODY AESTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "HUMPHRIES",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "904-472-5563",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.M.E."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "FB9712840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Body Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Toshfem Enterprises LLC
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• Total Care Medical Service Inc.
• Total Foot Care and Wellness Clinic, LLC
• Total Health Clinic LLC
• Total Health Clinic LLC
• Total Health Restoration LLC

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.