Active NPI
Skinique LLC
- Prosthetic/Orthotic Supplier
- Charlotte, NC
National Provider Identifier
1043120215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.