Uptown Dermatology & Skin Spa, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

UPTOWN DERMATOLOGY & SKIN SPA, P.A.

Practice address

1221 W Lake St
Suite 208
Minneapolis, MN 55408-3397

Phone

(612) 455-3200

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Jaime Davis, M.D.NPI 1326063439

Title

Owner

Phone

(612) 455-3200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 10

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

• Jaime Lee Davis, M.D.

  • Dermatology Physician
  • Minneapolis, MN
  • NPI 1326063439
  Medicare reassignment Care Compare group Authorized official
• Eric Harl, PA-C

  • Medical Physician Assistant
  • Shakopee, MN
  • NPI 1336297043
  Medicare reassignment Care Compare group
• Jason Davis, PA-C

  • Physician Assistant
  • St Louis Park, MN
  • NPI 1306170808
  Medicare reassignment
• Wendy Roberta Timmons, PAC

  • Physician Assistant
  • Buffalo, MN
  • NPI 1063508414
  Medicare reassignment
• Jaspreet K Prischmann, MD

  • Facial Plastic Surgery Physician
  • Minneapolis, MN
  • NPI 1710996921
  NPD
• Rehana Leila Ahmed-Saucedo, M.D., PH.D.

  • Dermatology Physician
  • Burnsville, MN
  • NPI 1427243898
  NPD (past)
• Alexander Dobbertin, MD

  • Anesthesiology Physician
  • Rochester, MN
  • NPI 1922052489
  NPD (past)
• Risa Ann Dorweiler, NP

  • Nurse Practitioner
  • Morris, MN
  • NPI 1144396862
  NPD (past)
• Rebekah Rose White, CNP

  • Family Nurse Practitioner
  • Baxter, MN
  • NPI 1598744997
  NPD (past)
• Carmen J Rinaldi, M.D.

  • Dermatology Physician
  • Portland, ME
  • NPI 1083694509
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205868619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W LAKE ST",
            "address_2": "SUITE 208",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083397",
            "telephone_number": "612-455-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W LAKE ST",
            "address_2": "SUITE 208",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083397",
            "telephone_number": "612-455-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN DERMATOLOGY & SKIN SPA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-455-3200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uptown Behavioral Health LLC
• Uptown Center for Psychotherapy LTD
• Uptown Chiropractic, LLC
• Uptown Counseling P a
• Uptown Dental Acquisition Company (Uptown Dental)
• Uptown Natural Care Center, P.a.
• Uptown Pharmacy Inc
• Uptown Psychology Group
• Uptown Smile LLC (Uptown Smile)
• Uptown Vision Clinic, PA (Uptown Vision Clinic)

• Dermatology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.