Organization Active NPI

Imaj Skin & Wellness Center LLC

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1194319517
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IMAJ SKIN & WELLNESS CENTER LLC
Practice address
10161 Park Run Dr Ste 150
Las Vegas, NV 89145-8872
Phone
(408) 833-3158
NPI assigned
Feb 25, 2021
Last updated
Aug 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Cherry M Lee, NPNPI 1487906673
Title
Ceo
Phone
(702) 782-8941

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Primary Care Nurse Practitioner 363LP2300X NU
Family Medicine Physician 207Q00000X NU Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU

Addresses

Primary practice location

10161 Park Run Dr Ste 150
Las Vegas, NV 89145-8872

Mailing address

10161 Park Run Dr Ste 150
Las Vegas, NV 89145-8872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210316001846 NV Part B Supplier - Clinic/Group Practice 3173939170 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

3827 E Sunset Rd
Ste G
Las Vegas, NV 89120
Phone (408) 833-3158

Practitioners & affiliated clinicians

Practitioners 3

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": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1194319517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10161 PARK RUN DR STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10161 PARK RUN DR STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458872",
            "telephone_number": "408-833-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAJ SKIN & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-782-8941",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "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 Aug 19, 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.

Verify at the official NPI Registry.