NPIMap

Organization Active NPI

Advanced Hair Care & Wellness Spa, LLC

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
National Provider Identifier
1952153249
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ADVANCED HAIR CARE & WELLNESS SPA, LLC
Practice address
1021 Oak St Ste 129
Jacksonville, FL 32204-3905
Phone
(904) 670-0906
NPI assigned
Apr 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Nicole ShemwellNPI 1164135810
Title
Certified Hair Loss Specialist
Phone
(904) 670-0906

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193200000X MULTI-SPECIALTY GROUP 1744P3200X
Orthotic FitterGroup: 193200000X MULTI-SPECIALTY GROUP 225000000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

1021 Oak St Ste 129
Jacksonville, FL 32204-3905

Mailing address

14587 Falling Waters Dr
Jacksonville, FL 32258-1162
Phone (904) 333-0868

National Provider Directory

National Provider Directory

Locations

1021 Oak St
Ste 129
Jacksonville, FL 32204
Phone (904) 670-0906

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": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1952153249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14587 FALLING WATERS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581162",
            "telephone_number": "904-333-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 OAK ST STE 129",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043905",
            "telephone_number": "904-670-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HAIR CARE & WELLNESS SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "SHEMWELL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CERTIFIED HAIR LOSS SPECIALIST",
        "authorized_official_telephone_number": "904-670-0906"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.