Skin Envy Dermatology

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SKIN ENVY DERMATOLOGY

Practice address

3140 Elk LN Ste 600
Fremont, NE 68025-8650

Phone

(402) 936-6198

Fax

(402) 816-4402

NPI assigned

Jan 11, 2019

Organization subpart

No

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

Authorized official

Name

Debra Lynn Baker, NPNPI 1619326709

Title

Owner/NP

Phone

(402) 936-6198

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Skin Envy Wayne LLC

  • Nurse Practitioner
  • Wayne, NE
  • NPI 1922962091
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra Baker, APRN

  • Nurse Practitioner
  • Fremont, NE
  • NPI 1619326709
  Medicare reassignment Care Compare group NPD Authorized official
• Brittany N Burbach, APRN

  • Family Nurse Practitioner
  • Fremont, NE
  • NPI 1841737467
  Medicare reassignment Care Compare group NPD
• Samantha Lynn Dorcey

  • Nurse Practitioner
  • Wayne, NE
  • NPI 1962366039
  NPD

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1154895209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 ELK LN STE 600",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680258650",
            "telephone_number": "402-936-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 ELK LN STE 600",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680258650",
            "telephone_number": "402-936-6198",
            "fax_number": "402-816-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN ENVY DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/NP",
        "authorized_official_telephone_number": "402-936-6198",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026733400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan J. Sieler, PT
• Lawrence Simbro
• Lisa Simonsen
• Jada Simpson, ATC, LAT
• Rachel Claire Sinley, R.D.
• Skin PC
• Sleep Center of Fremont, LLC.
• Jennifer Small
• Kelsea Small
• Leah Smeal

• Nurse Practitioner in Fremont, NE
• Providers in Fremont, NE by specialty
• Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.