Beautiful Me

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

004-0002290200-01 Issued in WI

Legal business name

BEAUTIFUL ME

Practice address

531 Valley View Dr
Fontana, WI 53125-1198

Phone

(262) 275-5000

NPI assigned

Dec 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Dale A. Johnson

Title

Owner

Phone

(262) 723-5555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1639352180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 VALLEY VIEW DRIVE",
            "city": "FONTANA",
            "state": "WI",
            "postal_code": "53125",
            "telephone_number": "262-275-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 VALLEY VIEW DR",
            "city": "FONTANA",
            "state": "WI",
            "postal_code": "531251198",
            "telephone_number": "262-275-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL ME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-723-5555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WI",
            "license": "004-0002290200-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy L Bria, DC
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• Joint School District 8 Fontana

• Prosthetic/Orthotic Supplier in Fontana, WI
• Providers in Fontana, WI by specialty
• Prosthetic/Orthotic Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.