Organization Active NPI

Luxe Beauty and Wellness Boutique

  • Family Nurse Practitioner
  • Bellflower, CA
National Provider Identifier
1689327025
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LUXE BEAUTY AND WELLNESS BOUTIQUE
Practice address
10242 Rosecrans Ave
Bellflower, CA 90706-2602
Phone
(562) 804-0000
NPI assigned
Jan 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Dr. Kiiyonna Jones, FNPNPI 1659029742
Title
Nurse Practitioner
Phone
(310) 654-9047

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X
Clinical Medical Laboratory 291U00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10242 Rosecrans Ave
Bellflower, CA 90706-2602

Mailing address

10242 Rosecrans Ave
Bellflower, CA 90706-2602
Phone (562) 804-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220303001272 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1850785080 Practice locations: Bellflower, CA

National Provider Directory

National Provider Directory

Locations

10242 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 804-0000

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": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1689327025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10242 ROSECRANS AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907062602",
            "telephone_number": "562-804-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10242 ROSECRANS AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907062602",
            "telephone_number": "562-804-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXE BEAUTY AND WELLNESS BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KIIYONNA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "310-654-9047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.