Pretty Essentials Women'S Boutique, LLC.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PRETTY ESSENTIALS WOMEN'S BOUTIQUE, LLC.

Doing business as

Pretty Essentials Women's Boutique

Practice address

661 Tiffany Blvd
Rocky Mount, NC 27804-1802

Phone

(919) 274-2461

NPI assigned

May 13, 2021

Organization subpart

No

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

Authorized official

Name

Keishia JusticeNPI 1093266496

Title

Chief Executive Officer/Member

Phone

(919) 274-2461

Specialties & licenses 2

Addresses

Other names 1

• Pretty Essentials Women's Boutique Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Keishia Justice, CMF

  • Mastectomy Fitter
  • Rocky Mount, NC
  • NPI 1093266496
  NPD Authorized official

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1780258863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 TIFFANY BLVD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041802",
            "telephone_number": "252-442-4233",
            "fax_number": "252-557-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 TIFFANY BLVD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041802",
            "telephone_number": "919-274-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRETTY ESSENTIALS WOMEN'S BOUTIQUE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "KEISHIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER/MEMBER",
        "authorized_official_telephone_number": "919-274-2461"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pretty Essentials Women's Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pretty Essentials Women's Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.