Revive Hair & Nail Solutions LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REVIVE HAIR & NAIL SOLUTIONS LLC

Practice address

2219 34TH St NW
Canton, OH 44709-2736

Phone

(123) 480-4151

NPI assigned

Oct 20, 2023

Organization subpart

No

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

Authorized official

Name

Lisa Cornelia AllenNPI 1114794583

Title

Owner

Phone

(234) 804-1515

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 3

• Lisas Creative Hair Replacement Studio Doing business as
• Revive Hair & Nail Solutions Doing business as
• Revive Hair & Nail Solutions LLC Other name

Practitioners 1

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

• Lisa Cornelia Allen

  • Prosthetics Case Management
  • Canton, OH
  • NPI 1114794583
  NPD Authorized official

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1609658996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 34TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092736",
            "telephone_number": "234-804-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 34TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092736",
            "telephone_number": "123-480-4151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2219 34th St NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447092736",
            "country_code": "US",
            "telephone_number": "123-480-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE HAIR & NAIL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "CORNELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "234-804-1515"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI SPECIALTY GROUP",
            "identifier": "19320000X",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHOTIC SUPPLIER",
            "identifier": "335E00000X",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROSTHETICS CASE MANAGER",
            "identifier": "1744P3200X",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EQUIPMENT AND MEDICAL SUPPLIES",
            "identifier": "332B00000X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lisas Creative Hair Replacement Studio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revive Hair & Nail Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revive Hair & Nail Solutions LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Canton, OH
• Providers in Canton, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.