NPIMap

Organization Active NPI

Tailor Made Looks Institute of Plastic Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Atlanta, GA
National Provider Identifier
1952791147
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
20800000X Issued in GA
Legal business name
TAILOR MADE LOOKS INSTITUTE OF PLASTIC SURGERY LLC
Practice address
3193 Howell Mill Rd NW
Suite 328
Atlanta, GA 30327-2119
Phone
(404) 350-9355
Fax
(404) 350-9069
NPI assigned
Jan 27, 2015
Last updated
Feb 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Dr. Medhanie Chichi Berhane, M.D.NPI 1770797904
Title
Surgeon
Phone
(404) 350-9355

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
Ambulatory Surgical Clinic/Center 261QA1903X 20800000X GA Primary

Addresses

Primary practice location

3193 Howell Mill Rd NW
Suite 328
Atlanta, GA 30327-2119

Mailing address

3193 Howell Mill Rd NW
Suite 328
Atlanta, GA 30327-2119
Phone (404) 350-9355

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, 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": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1952791147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3193 HOWELL MILL RD NW",
            "address_2": "SUITE 328",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272119",
            "telephone_number": "404-350-9355",
            "fax_number": "404-350-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3193 HOWELL MILL RD NW",
            "address_2": "SUITE 328",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272119",
            "telephone_number": "404-350-9355",
            "fax_number": "404-350-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAILOR MADE LOOKS INSTITUTE OF PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "BERHANE",
        "authorized_official_first_name": "MEDHANIE",
        "authorized_official_middle_name": "CHICHI",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "404-350-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "20800000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.