Beauticians on the Go, PLLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

10223435 Issued in AZ

Legal business name

BEAUTICIANS ON THE GO, PLLC

Practice address

2390 E Camelback Rd Ste 130
Phoenix, AZ 85016-3449

Phone

(602) 803-2827

Fax

(602) 218-4498

NPI assigned

Oct 27, 2017

Organization subpart

No

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

Authorized official

Name

Carla R Olivares, COSMETOLOGISTNPI 1922596915

Title

Ceo

Phone

(602) 803-2827

Specialties & licenses 3

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carla R Olivares

  • Podiatrist
  • Phoenix, AZ
  • NPI 1922596915
  NPD (past) Authorized official

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1972015105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74322",
            "city": "NEW RIVER",
            "state": "AZ",
            "postal_code": "850871006",
            "telephone_number": "602-803-2728",
            "fax_number": "602-218-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 E CAMELBACK RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163449",
            "telephone_number": "602-803-2827",
            "fax_number": "602-218-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTICIANS ON THE GO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-27",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "OLIVARES",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-803-2827",
        "authorized_official_credential": "COSMETOLOGIST"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "10223435",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AZ",
            "license": "10223435",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "AZ",
            "license": "10223435",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON- MEDICARE",
            "identifier": "1972015105",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972015105",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlo Beaudoin
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• Carrie L. Beaumont, DPT
• Julie Beaumont, PA (ASCP)
• Sarah W Beaumont, M.D.
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• Home Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.