NPIMap

Organization Active NPI

A Beautiful You Mastectomy Boutique

  • Durable Medical Equipment & Medical Supplies
  • Caldwell, ID
National Provider Identifier
1902202708
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
CFM02746 Issued in ID
Legal business name
A BEAUTIFUL YOU MASTECTOMY BOUTIQUE
Practice address
2006 Blaine St
Caldwell, ID 83605-4343
Phone
(208) 985-5404
Fax
(208) 402-5959
NPI assigned
Nov 6, 2014
Last updated
Nov 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Leanne Kovick, CFMNPI 1962804120
Title
President
Phone
(208) 985-5404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X CFM02746 ID Primary

Addresses

Primary practice location

2006 Blaine St
Caldwell, ID 83605-4343

Mailing address

2006 Blaine St
Caldwell, ID 83605-4343
Phone (208) 985-5404

National Provider Directory

National Provider Directory
Tax ID family
A Beautiful You Mastectomy Boutique2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2006 Blaine St
Caldwell, ID 83605
Phone (208) 454-3430

Practitioners & affiliated clinicians

Practitioners 1

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": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1902202708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 BLAINE ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054343",
            "telephone_number": "208-985-5404",
            "fax_number": "208-402-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 BLAINE ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054343",
            "telephone_number": "208-985-5404",
            "fax_number": "208-402-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BEAUTIFUL YOU MASTECTOMY BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "KOVICK",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-985-5404",
        "authorized_official_credential": "CFM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "CFM02746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.