Nicole Clark, HAIR LOSS SPECIALIST

Primary specialty

ProsthetistTaxonomy code 224P00000X

Practice address

100 N Burke Ave
Long Beach, MS 39560-4605

Phone

(228) 234-1658

NPI assigned

Apr 1, 2019

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• NNC Services LLC,

  dba All About Hair

  • Prosthetic/Orthotic Supplier
  • Long Beach, MS
  • NPI 1134835804
  NPD Authorized official

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1386106375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BURKE AVE",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604605",
            "telephone_number": "228-234-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BURKE AVE",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604605",
            "telephone_number": "228-234-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NICOLE",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kathryn Cameron, PHARM D
• Michael Kollin Cannon, PT
• Samuel Carr
• Megan Nicole Case, SLP
• Brenda Lee Chapman
• Richard Clark
• Rosie Love Clark
• Jennifer Ruth Clarke, FNP
• Coast Family Physicians, P.a.
• Coastal Christian Counseling

• Prosthetist in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Prosthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.