Bella256 Boutique LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BELLA256 BOUTIQUE LLC

Practice address

1251 Hawthorne Cir
Madison, GA 30650-5099

Phone

(256) 453-9070

NPI assigned

Jun 12, 2025

Last updated

Jun 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa S Lyles, RNNPI 1922647577

Title

President

Phone

(256) 453-9070

Specialties & licenses 2

Addresses

Other names 1

• Bella256 Boutique LLC Former legal business name

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.

• Lisa Lyles

  • Contractor
  • Madison, GA
  • NPI 1922647577
  NPD Authorized official

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1619862273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 HAWTHORNE CIR",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306505099",
            "telephone_number": "256-453-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 HAWTHORNE CIR",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306505099",
            "telephone_number": "256-453-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA256 BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-453-9070",
        "authorized_official_credential": "RN"
    },
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella256 Boutique LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.