Organization Active NPI

Blooming Lemon Wellness and Aesthetics, PC

  • Interventional Pain Medicine Physician
  • Laramie, WY
National Provider Identifier
1689135956
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
BLOOMING LEMON WELLNESS AND AESTHETICS, PC
Practice address
709 E Grand Ave
Laramie, WY 82070-3945
Phone
(970) 688-1975
NPI assigned
Mar 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Authorized official

Name
Dr. David Hile, MDNPI 1225248842
Title
President
Phone
(970) 688-1975

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

709 E Grand Ave
Laramie, WY 82070-3945

Mailing address

709 E Grand Ave
Laramie, WY 82070-3945

National Provider Directory

National Provider Directory

Locations

709 E Grand Ave
Laramie, WY 82070
Phone (970) 688-1975

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1689135956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 E GRAND AVE",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 E GRAND AVE",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703945",
            "telephone_number": "970-688-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING LEMON WELLNESS AND AESTHETICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "HILE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-688-1975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.