NPIMap

Organization Active NPI

Douglas Med Spa LLC

  • Clinic/Center
  • Douglas, WY
National Provider Identifier
1548976368
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DOUGLAS MED SPA LLC
Practice address
119 N 3Rd St
Douglas, WY 82633-2136
Phone
(307) 358-5244
NPI assigned
Jan 25, 2023
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Cody ThomasNPI 1215642640
Title
Owner
Phone
(307) 358-5244

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

119 N 3Rd St
Douglas, WY 82633-2136

Mailing address

119 N 3Rd St
Douglas, WY 82633-2136

National Provider Directory

National Provider Directory

Locations

119 N 3rd St
Douglas, WY 82633
Phone (307) 358-5244

Practitioners & affiliated clinicians

Practitioners 3

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": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1548976368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N 3RD ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N 3RD ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332136",
            "telephone_number": "307-358-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MED SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-358-5244"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.