NPIMap

Organization Active NPI

Mulberry Wellness Salon LLC

  • Prosthetic/Orthotic Supplier
  • Montgomery, AL
National Provider Identifier
1669732301
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
39089 Issued in AL
Legal business name
MULBERRY WELLNESS SALON LLC
Practice address
1734 Mulberry St
Montgomery, AL 36106-1524
Phone
(334) 819-7249
Fax
(334) 819-7249
NPI assigned
May 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Ms. Ramona J Washington, CERTIFIED HAIR LOSS
Title
Master Cosmetologist/Owner
Phone
(334) 868-5189

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 161733 AL
Prosthetics Case ManagementGroup: 193200000X MULTI-SPECIALTY GROUP 1744P3200X 39089 AL
Customized Equipment (DME) 332BC3200X 161733 AL
Prosthetic/Orthotic Supplier 335E00000X 39089 AL Primary

Addresses

Primary practice location

1734 Mulberry St
Montgomery, AL 36106-1524

Mailing address

1734 Mulberry St
Montgomery, AL 36106-1524
Phone (334) 819-7249

Other identifiers 1

IdentifierTypeStateIssuer
39089OtherALMASTER COSMETOLOGIST; NON-SURGICAL HAIR REPLACEMENT

National Provider Directory

National Provider Directory

Locations

1734 Mulberry St
Montgomery, AL 36106
Phone (334) 819-7249

NPI Registry JSON

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

{
    "created_epoch": "1338163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1669732301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061524",
            "telephone_number": "334-819-7249",
            "fax_number": "334-819-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061524",
            "telephone_number": "334-819-7249",
            "fax_number": "334-819-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY WELLNESS SALON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-28",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MASTER COSMETOLOGIST/OWNER",
        "authorized_official_telephone_number": "334-868-5189",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CERTIFIED HAIR LOSS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "161733",
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "AL",
            "license": "39089",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AL",
            "license": "161733",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AL",
            "license": "39089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTER COSMETOLOGIST; NON-SURGICAL HAIR REPLACEMENT",
            "identifier": "39089",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.