NPIMap

Organization Active NPI

Reviving Crowns Solutions LLC

  • Prosthetic/Orthotic Supplier
  • Lawrenceville, GA
National Provider Identifier
1467150110
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
REVIVING CROWNS SOLUTIONS LLC
Practice address
1812 N Brown Rd Ste 30-113
Lawrenceville, GA 30043-1801
Phone
(770) 580-2380
Fax
(770) 628-5144
NPI assigned
Feb 22, 2023
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Marquisha Shankeia General, HAIR LOSS SPECIALISTNPI 1295351302
Title
Owner
Phone
(770) 580-2380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

1812 N Brown Rd Ste 30-113
Lawrenceville, GA 30043-1801

Mailing address

3379 Peachtree Rd NE Ste 655-S24
Atlanta, GA 30326-1031
Phone (770) 580-2380

Other names 1

  • Reviving Crowns Solutions Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Reviving Crowns Solutions LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3379 Peachtree Rd NE
Ste 655S24
Atlanta, GA 30326

1812 N Brown Rd
Ste 30113
Lawrenceville, GA 30043
Phone (770) 580-2380

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1467150110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 PEACHTREE RD NE STE 655-S24",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261031",
            "telephone_number": "770-580-2380",
            "fax_number": "770-628-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 N BROWN RD STE 30-113",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300431801",
            "telephone_number": "770-580-2380",
            "fax_number": "770-628-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVING CROWNS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "GENERAL",
        "authorized_official_first_name": "MARQUISHA",
        "authorized_official_middle_name": "SHANKEIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-580-2380",
        "authorized_official_credential": "HAIR LOSS SPECIALIST"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reviving Crowns Solutions",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Reviving Crowns Solutions",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.