Active NPI
Ian Bradley Hair Salon LLC
- Health Service Clinic/Center
- Macon, GA
National Provider Identifier
1437980083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- Legal business name
- IAN BRADLEY HAIR SALON LLC
- Practice address
- 3902 Northside Dr Ste A3
Macon, GA 31210-2459 - Phone
- (478) 845-1210
- NPI assigned
- Aug 13, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | 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 LLC
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetics Case Management
- Macon, GA
- NPI 1285144733
-
- Prosthetic/Orthotic Supplier
- Macon, GA
- NPI 1073239265
-
- Durable Medical Equipment & Medical Supplies
- Macon, GA
- NPI 1265158455
-
- Prosthetist
- Macon, GA
- NPI 1427889112
Locations
3902 Northside Dr
Ste A3
Macon, GA 31210
Phone (478) 845-1210
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": "1437980083",
"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"
}
],
"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": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"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.