NPIMap

Organization Active NPI

Prima Donna Salon

  • Durable Medical Equipment & Medical Supplies
  • Belleville, IL
National Provider Identifier
1891230744
Registry record updated Jan 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
011307091 Issued in IL
Legal business name
PRIMA DONNA SALON
Practice address
333 Longview Dr
Belleville, IL 62223-4101
Phone
(618) 580-2584
Fax
(618) 277-0639
NPI assigned
Jan 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2017

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

Authorized official

Name
Ms. Chauna Yvette PayneNPI 1164959060
Title
Owner
Phone
(618) 580-2584

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
Durable Medical Equipment & Medical Supplies 332B00000X 011307091 IL Primary
Prosthetic/Orthotic Supplier 335E00000X 011307091 IL

Addresses

Primary practice location

333 Longview Dr
Belleville, IL 62223-4101

Mailing address

333 Longview Dr
Belleville, IL 62223-4101
Phone (618) 580-2584

Other names 1

  • Payne's Cosmetologic Institute Other name

National Provider Directory

National Provider Directory

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": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483315200000",
    "number": "1891230744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 LONGVIEW DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622234101",
            "telephone_number": "618-580-2584",
            "fax_number": "618-277-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LONGVIEW DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622234101",
            "telephone_number": "618-580-2584",
            "fax_number": "618-277-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA DONNA SALON",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-02",
        "last_updated": "2017-01-02",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "CHAUNA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-580-2584",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "011307091",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "011307091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payne's Cosmetologic Institute",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; 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.