Active NPI
Skin Aid LLC
- Wound Care Registered Nurse
- Las Vegas, NV
National Provider Identifier
1003617242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Wound Care Registered Nurse
- Legal business name
- SKIN AID LLC
- Practice address
- 7784 Cape Cod Bay CT
Las Vegas, NV 89179-1425 - Phone
- (702) 741-8825
- NPI assigned
- Mar 24, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theresa Montecillo, NP
- Title
- Ceo
- Phone
- (702) 826-0956
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | Primary | ||
| Primary Care Nurse Practitioner | 363LP2300X |
Addresses
Primary practice location
7784 Cape Cod Bay CT
Las Vegas, NV 89179-1425
Mailing address
7784 Cape Cod Bay CT
Las Vegas, NV 89179-1425
Phone (702) 826-0956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & 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": "1742774400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1743552000000",
"number": "1003617242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7784 CAPE COD BAY CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891791425",
"telephone_number": "702-826-0956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7784 CAPE COD BAY CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891791425",
"telephone_number": "702-741-8825"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SKIN AID LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-24",
"last_updated": "2025-04-02",
"certification_date": "2025-04-02",
"status": "A",
"authorized_official_last_name": "MONTECILLO",
"authorized_official_first_name": "THERESA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "702-826-0956",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Wound Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.