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NPI profile

TAILOR MADE COMPOUNDING

NPI record status, taxonomy, official source timestamp, and OIG LEIE screening context.

NPI record foundexcludedNPI API source

Identity

NPI
1235591165
Entity type
NPI-2
Primary taxonomy
3336C0004X
NPI source updated
Mar 21, 2016
Enumeration date
Mar 21, 2016
Cache fetched
May 05, 2026

NPI does not validate licensure, credentialing, Medicare enrollment, or current practice authority.

OIG LEIE screening

excludedConfidence: high

Exact OIG exclusion match by NPI.

NPI addresses

NPI addresses from the official registry record
PurposeAddressPhone
MAILING8598870013
LOCATION8598870013

FAQ

Practical notes

Does an NPI record validate licensure?

No. NPI data does not validate licensure, credentialing, Medicare enrollment, or current practice authority.