Signature Surgical Arts and Medspa PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

SIGNATURE SURGICAL ARTS AND MEDSPA PLLC

Doing business as

Signature Surgical Arts and MedSpa

Practice address

3100 N Wellness Dr
Holland, MI 49424-8122

Phone

(616) 396-1433

NPI assigned

Aug 10, 2020

Last updated

Oct 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason T Stubbs, DO

Title

Owner/Physician

Phone

(812) 639-4570

Specialties & licenses 2

Addresses

Other names 1

• Signature Surgical Arts and MedSpa Doing business as

Locations

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1740891274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 N WELLNESS DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248122",
            "telephone_number": "616-396-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 N WELLNESS DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248122",
            "telephone_number": "616-396-1433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Rivertown Point Ct SW",
            "address_purpose": "LOCATION",
            "city": "Grandville",
            "state": "MI",
            "postal_code": "494183038",
            "country_code": "US",
            "telephone_number": "616-396-1433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIGNATURE SURGICAL ARTS AND MEDSPA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "STUBBS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "812-639-4570",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Surgical Arts and MedSpa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Plastic and Reconstructive Surgery Physician in Holland, MI
• Providers in Holland, MI by specialty
• Plastic and Reconstructive Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.