Robocalls and caller ID spoofing have become a growing concern in recent years, with a staggering 40.7 billion robocalls reported in 2019 according to the FTC. In response, the FCC developed authentication protocols to help carriers verify legitimate calls and protect consumers.
Aesthetix CRM helps your practice stay compliant and trusted by registering your phone numbers with CNAM, SHAKEN/STIR, and Voice Integrity through our telephony partner, Twilio.
CNAM stands for Caller Name Delivery (or Caller Name Presentation). It’s the name that appears next to your phone number when you call someone.
When a call is placed, the receiving carrier often checks a CNAM database to find the name associated with your number and display it on the recipient’s screen. For medical aesthetic practices, a properly registered CNAM ensures patients recognize your practice rather than seeing an unfamiliar number.
CNAM registration associates your practice name with your phone number in industry databases.
The display name is not transmitted with the call—it’s retrieved by the receiving carrier.
Each carrier may show different caller name results (or none at all).
The CNAM display name typically allows up to 15 characters.
CNAM improves professionalism and trust, but display cannot be guaranteed by any single provider.
SHAKEN/STIR is a framework of digital authentication protocols designed to combat spoofing and illegal robocalls.
STIR (Secure Telephone Identity Revisited) defines how to attach a digital certificate to a call, confirming that it truly originates from the claimed phone number.
SHAKEN (Signature-based Handling of Asserted information using toKENs) defines how carriers verify and share that authentication across networks.
Calls are assigned attestation levels (A, B, C) to indicate how confidently the network can vouch for the caller’s identity.
When your calls are authenticated through SHAKEN/STIR, carriers can trust that your calls are legitimate—helping reduce the chance that your number is flagged as spam.
Voice Integrity is a Twilio service that registers your phone numbers with the major caller-ID analytics providers carriers rely on to label calls. These providers review your numbers and calling activity, which helps prevent and correct incorrect "Spam Likely" or "Scam Likely" labels.
Together, the three registrations cover every layer of caller trust:
Layer | Registration | What It Does |
|---|---|---|
Identification | CNAM | Shows your practice name with your number |
Authentication | SHAKEN/STIR | Digitally verifies your calls really come from your number |
Reputation | Voice Integrity | Registers your numbers with analytics providers to reduce spam labeling |
Voice Integrity applies to U.S. phone numbers.
Our team manages caller ID registration for your practice through Twilio:
We register every phone number in your practice's Twilio account.
Each number is registered with CNAM under your practice name via Twilio.
We ensure those numbers are configured for SHAKEN/STIR attestation to enable digital call authentication.
Each number is registered for Voice Integrity to protect its reputation with carrier spam-labeling systems.
Once complete, your outbound calls are recognized as legitimate and associated with your brand identity wherever possible.
If you add any new outbound numbers after onboarding, please submit them to Aesthetix CRM Support for CNAM, SHAKEN/STIR, and Voice Integrity registration.
Unregistered numbers may still function, but they won’t benefit from authenticated caller ID and are more likely to appear as “Unknown,” “Spam Risk,” or “Scam Likely.”
Aesthetix CRM properly submits all CNAM and SHAKEN/STIR information through Twilio on your behalf.
We cannot guarantee that all carrier networks will display your registered caller name. - Display depends on each carrier’s lookup database, update cycles, and device behavior.
SHAKEN/STIR attestation verifies authenticity but does not guarantee your calls won’t be flagged or blocked by carriers’ analytics or reputation systems.
CNAM updates can take time to propagate across networks and databases.
Voice Integrity does not guarantee spam labels will be removed or never return. Each analytics provider and carrier makes its own decisions, label changes can take time to reach every network, and providers keep evaluating call volume, complaints, and calling patterns.
Even with these limitations, registering CNAM and SHAKEN/STIR gives your practice the highest possible trust and recognition within carrier systems.
Note which number is affected and which label patients are seeing (for example, "Spam Likely"), plus the carriers involved if you know them.
Contact Aesthetix CRM Support with those details so we can review the number's registrations.
Review your recent calling activity. Sudden spikes in volume, very short calls, or calls to people who haven't asked to hear from you can all hurt a number's reputation.
If the label doesn't clear over time, ask Support whether replacing the number makes sense.
Use a consistent, recognizable CNAM (e.g., “Studio Esthetique Skin” instead of “Esthetique Calls”).
Keep call volumes steady and relevant to typical patient communications.
Contact Aesthetix CRM Support if you notice low answer rates or spam labeling.
Always register new numbers before using them for patient outreach.
Avoid reusing numbers across multiple brands or names without updating CNAM.
By registering your practice numbers through CNAM, SHAKEN/STIR, and Voice Integrity, Aesthetix CRM helps ensure your calls are authenticated, identifiable, and trusted. While we cannot control how each carrier displays your name, we handle all proper registrations to give your calls the best possible chance of reaching patients clearly and securely.
