Divine Beauty & Wellness LLC

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Legal business name

DIVINE BEAUTY & WELLNESS LLC

Practice address

6340 Security Blvd Ste 100
Baltimore, MD 21207-5284

Phone

(410) 304-3127

NPI assigned

Feb 9, 2018

Organization subpart

No

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

Authorized official

Name

Tyrahna Jefferson, CERTIFIED HAIR LOSSNPI 1649629064

Title

Ceo/Owner

Phone

(410) 304-3127

Specialties & licenses 2

Addresses

Practitioners 1

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

• Tyrahna Jefferson, CRANIAL PROSTHESIS

  • Prosthetics Case Management
  • Baltimore, MD
  • NPI 1649629064

  Reflexologist

  NPD (past) Authorized official

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1578062055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8125 SUBET RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442973",
            "telephone_number": "443-744-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212075284",
            "telephone_number": "410-304-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE BEAUTY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-09",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "TYRAHNA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "410-304-3127",
        "authorized_official_credential": "CERTIFIED HAIR LOSS"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nisha Divakaruni, M.D.
• Sai Sachin Divakaruni, MD, PHD
• Sara A Divall, M.D.
• Diverleaf LLC
• Diverse Supports Inc.
• Divine Care Family Practice, LLC
• Divine Care Pharmacy
• Divine Care Solutions
• Divine Dental LLC (Brooklyn Park Dental Center)
• Divine Grace Health Services

• Prosthetics Case Management in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Prosthetics Case Management in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.