NPIMap

Organization Active NPI

Stage 1 Hair Loss Replacement & Salon

  • Durable Medical Equipment & Medical Supplies
  • Meadville, MS
National Provider Identifier
1528764784
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
STAGE 1 HAIR LOSS REPLACEMENT & SALON
Practice address
216 Main Street
Meadville, MS 39653
Phone
(601) 384-4532
Fax
(601) 384-8334
NPI assigned
Jan 31, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Mrs. Alanda K TillmanNPI 1306214507
Title
Provider
Phone
(601) 384-4532

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

216 Main Street
Meadville, MS 39653

Mailing address

PO Box 240
Meadville, MS 39653-0240
Phone (601) 384-4532

Other identifiers 1

IdentifierTypeStateIssuer
1306214507MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Stage 1 Hair Loss Replacement Salon2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1528764784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396530240",
            "telephone_number": "601-384-4532",
            "fax_number": "601-384-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MAIN STREET",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "39653",
            "telephone_number": "601-384-4532",
            "fax_number": "601-384-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAGE 1 HAIR LOSS REPLACEMENT & SALON",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "ALANDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "601-384-4532",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306214507",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.