Organization Active NPI

Skinique LLC

  • Prosthetic/Orthotic Supplier
  • Charlotte, NC
National Provider Identifier
1043120215
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
SKINIQUE LLC
Practice address
11709 Fruehauf Dr Ste 222
Charlotte, NC 28273-0043
Phone
(704) 904-7898
NPI assigned
Sep 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Regjinique Harris, BS,LE
Title
Owner
Phone
(704) 904-7898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

11709 Fruehauf Dr Ste 222
Charlotte, NC 28273-0043

Mailing address

12924 Lake Erie LN
Charlotte, NC 28273-7145
Phone (704) 904-7898

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1043120215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12924 LAKE ERIE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282737145",
            "telephone_number": "704-904-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11709 FRUEHAUF DR STE 222",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730043",
            "telephone_number": "704-904-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "REGJINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-904-7898",
        "authorized_official_credential": "BS,LE"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.