NPIMap

Organization Active NPI

Ian Bradley Hair Salon LLC

  • Prosthetist
  • Macon, GA
National Provider Identifier
1427889112
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Legal business name
IAN BRADLEY HAIR SALON LLC
Practice address
3902 Northside Dr Ste A3
Macon, GA 31210-2459
Phone
(478) 845-1210
Fax
(478) 210-5078
NPI assigned
Aug 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Mrs. Melissa Ralee McCoy
Title
Manager
Phone
(478) 845-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthetistGroup: 193400000X SINGLE SPECIALTY GROUP 224P00000X Primary

Addresses

Primary practice location

3902 Northside Dr Ste A3
Macon, GA 31210-2459

Mailing address

222 Joycliff Cir
Macon, GA 31211-7040

National Provider Directory

National Provider Directory
Tax ID family
Ian Bradley Hair Salon LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1427889112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 JOYCLIFF CIR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312117040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 NORTHSIDE DR STE A3",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102459",
            "telephone_number": "478-845-1210",
            "fax_number": "478-210-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN BRADLEY HAIR SALON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "RALEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "478-845-1210",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.