Edge Luxe Image Consulting LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

EDGE LUXE IMAGE CONSULTING LLC

Practice address

112 Magnolia St
Beavercreek, OH 45440-1370

Phone

(937) 241-2972

NPI assigned

Aug 27, 2013

Organization subpart

No

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

Authorized official

Name

Chandi Rae Bozeman

Title

Owner

Phone

(937) 241-2972

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1700210689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MAGNOLIA ST",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454401370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAGNOLIA ST",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454401370",
            "telephone_number": "937-241-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE LUXE IMAGE CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "BOZEMAN",
        "authorized_official_first_name": "CHANDI",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-241-2972"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Durning, CNP
• Kyler Benjamin Dykes, MD
• Dynamic Senior Solutions
• Tara Nicole Eades
• Denise Easthon, CD(DONA), LCCE, ELCS
• Isabel Kathleen Edwards
• Katherine Edwards, RN
• Katherine J Egan, OT
• Destiny Ellington
• Nathaniel Duke Ellis, LPCC

• Prosthetic/Orthotic Supplier in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Prosthetic/Orthotic Supplier in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.