NPIMap

Organization Active NPI

Olysis, LLC

Doing business as Olysis Med Spa

  • Medical Specialty Clinic/Center
  • Roanoke, TX
National Provider Identifier
1841078946
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
OLYSIS, LLC
Doing business as
Olysis Med Spa
Practice address
509 E Byron Nelson Blvd Ste C
Roanoke, TX 76262-6183
Phone
(682) 593-1442
NPI assigned
Sep 19, 2023
Last updated
Mar 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

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

Authorized official

Name
Ms. Jamie Johnson, CPENPI 1407584733
Title
Owner / Electrologist
Phone
(214) 326-5721

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary
Specialist 174400000X

Addresses

Primary practice location

509 E Byron Nelson Blvd Ste C
Roanoke, TX 76262-6183

Mailing address

509 E Byron Nelson Blvd Ste C
Roanoke, TX 76262-6183
Phone (682) 593-1442

Other names 1

  • Olysis Med Spa Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address welcome@olysismedspa.com Direct

National Provider Directory

National Provider Directory

Locations

509 E Byron Nelson Blvd
Ste C
Roanoke, TX 76262
Phone (214) 326-5721

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741996800000",
    "number": "1841078946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 E BYRON NELSON BLVD STE C",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762626183",
            "telephone_number": "682-593-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 E BYRON NELSON BLVD STE C",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762626183",
            "telephone_number": "682-593-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER / ELECTROLOGIST",
        "authorized_official_telephone_number": "214-326-5721",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPE"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "welcome@olysismedspa.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "509 E Byron Nelson Blvd Ste C",
            "city": "Roanoke",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762626183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Olysis Med Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2025; 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.