NPIMap

Organization Active NPI

Tiamson Inc

Doing business as Shylee Skin Wellness and Family Practice

  • Family Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1124745161
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TIAMSON INC
Doing business as
Shylee Skin Wellness and Family Practice
Practice address
10570 Foothill Blvd Ste 220
Rancho Cucamonga, CA 91730-3876
Phone
(909) 808-4888
NPI assigned
Oct 20, 2022
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Shylee Baustista Tiamson, NPNPI 1053779322
Title
Authorized Office / Owner
Phone
(909) 808-4888

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0000X
Physical Therapy Clinic/Center 261QP2000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10570 Foothill Blvd Ste 220
Rancho Cucamonga, CA 91730-3876

Mailing address

10570 Foothill Blvd Ste 220
Rancho Cucamonga, CA 91730-3876
Phone (909) 808-4888

Other names 1

  • Shylee Skin Wellness and Family Practice Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clinic@shyleeskin.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230221002012 CA Part B Supplier - Clinic/Group Practice 5193197168 Receives reassigned benefits from 10 practitioners
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

10570 Foothill Blvd
Ste 220
Rancho Cucamonga, CA 91730
Phone (909) 808-4888

Interoperability endpoints

  • Direct secure messaging: clinic@shyleeskin.com

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1124745161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10570 FOOTHILL BLVD STE 220",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303876",
            "telephone_number": "909-808-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10570 FOOTHILL BLVD STE 220",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303876",
            "telephone_number": "909-808-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIAMSON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "TIAMSON",
        "authorized_official_first_name": "SHYLEE",
        "authorized_official_middle_name": "BAUSTISTA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICE / OWNER",
        "authorized_official_telephone_number": "909-808-4888",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinic@shyleeskin.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10570 Foothill Blvd Ste 220",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917303876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shylee Skin Wellness and Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shylee Skin Wellness and Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.

Verify at the official NPI Registry.