NPIMap

Organization Active NPI

Venus Hair Loss Replacement Center LLC

  • Interpreter
  • O Fallon, IL
National Provider Identifier
1942859558
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
InterpreterTaxonomy code 171R00000X
Legal business name
VENUS HAIR LOSS REPLACEMENT CENTER LLC
Practice address
625 S Lincoln Ave
O Fallon, IL 62269-2663
Phone
(618) 401-6359
NPI assigned
Sep 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Authorized official

Name
Akossiwa Tatiane Amenyo, CERTIFIED
Title
Hair Loss Specialist
Phone
(618) 401-6359

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
InterpreterGroup: 193200000X MULTI-SPECIALTY GROUP 171R00000X Primary
ProsthetistGroup: 193200000X MULTI-SPECIALTY GROUP 224P00000X

Addresses

Primary practice location

625 S Lincoln Ave
O Fallon, IL 62269-2663

Mailing address

625 S Lincoln Ave
O Fallon, IL 62269-2663
Phone (618) 401-6359

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Joholt456@gmail.com

National Provider Directory

National Provider Directory
Tax ID family
Venus Hair Loss Replacement Center LLC2 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

625 S Lincoln Ave
O Fallon, IL 62269
Phone (618) 401-6359

NPI Registry JSON

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1942859558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692663",
            "telephone_number": "618-401-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692663",
            "telephone_number": "618-401-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENUS HAIR LOSS REPLACEMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "AMENYO",
        "authorized_official_first_name": "AKOSSIWA",
        "authorized_official_middle_name": "TATIANE",
        "authorized_official_title_or_position": "HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "618-401-6359",
        "authorized_official_credential": "CERTIFIED"
    },
    "taxonomies": [
        {
            "code": "171R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Interpreter",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Joholt456@gmail.com",
            "affiliation": "N",
            "address_1": "625 S Lincoln Ave",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622692663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.