Imagine Medispa

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN77359-FNP-BC Issued in WV

Legal business name

IMAGINE MEDISPA

Practice address

321 Dry Hill Rd
Beckley, WV 25801-2601

Phone

(304) 252-4154

NPI assigned

Oct 10, 2013

Last updated

Oct 10, 2013By 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

Mrs. Christina Lea Phares, FNP-BCNPI 1689072605

Title

Nurse Practitioner

Phone

(304) 574-6144

Specialties & licenses 1

Addresses

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.

• Christina L. Phares, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Beckley, WV
  • NPI 1689072605

  Family

  NPD (past) Authorized official

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1407283245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 OAKWOOD CIR",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258406648",
            "telephone_number": "304-574-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 DRY HILL RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012601",
            "telephone_number": "304-252-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE MEDISPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "PHARES",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "304-574-6144",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN77359-FNP-BC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean-Michel Hyacinthe, MD
• Christina Hylton
• Ann Iams
• Ulagappan Ilangovan, RPH
• Iligino Fernandez Salon, MD, Inc
• Fausto Imbing, MD
• Independent Medical Services, PLLC
• Infrarad PLLC
• Infuse One LLC
• Rachel Ingram, SLP

• Family Nurse Practitioner in Beckley, WV
• Providers in Beckley, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.