NPIMap

Organization Active NPI

Med Spa for Me, Inc.

Doing business as Johnson-Miller Funeral Chapel, PC

  • General Practice Registered Nurse
  • Bellwood, IL
National Provider Identifier
1437982931
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
Legal business name
MED SPA FOR ME, INC.
Doing business as
Johnson-Miller Funeral Chapel, PC
Practice address
4000 Saint Charles Rd
Bellwood, IL 60104-1133
Phone
(707) 267-4100
NPI assigned
Aug 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Ms. Carrie Johnson, RNNPI 1518786730
Title
President
Phone
(708) 267-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WG0000X Primary
Infusion Therapy Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WI0500X
Pain Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0000X
Urology Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WU0100X

Addresses

Primary practice location

4000 Saint Charles Rd
Bellwood, IL 60104-1133

Mailing address

4000 Saint Charles Rd
Bellwood, IL 60104-1133
Phone (707) 267-4100

Other names 1

  • Johnson-Miller Funeral Chapel, PC Doing business as

National Provider Directory

National Provider Directory

Locations

4000 Saint Charles Rd
Bellwood, IL 60104
Phone (707) 267-4100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1437982931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SAINT CHARLES RD",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041133",
            "telephone_number": "707-267-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SAINT CHARLES RD",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041133",
            "telephone_number": "707-267-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED SPA FOR ME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-267-4100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WU0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson-Miller Funeral Chapel, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.