Flawless Skin IV Hydration Med Spa

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

FLAWLESS SKIN IV HYDRATION MED SPA

Practice address

25101 The Old Rd
Stevenson Ranch, CA 91381-2206

Phone

(323) 538-1110

NPI assigned

Jan 2, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Edith Ellis, DNP,MSN,CNL,RNNPI 1801326970

Title

Founder/Ceo

Phone

(323) 538-1110

Specialties & licenses 7

Addresses

Other names 1

• Flawless Skin IV Hydration Med Spa Doing business as

Practitioners 1

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

• Edith Ellis, RN

  • Registered Nurse
  • Torrance, CA
  • NPI 1801326970
  NPD Authorized official

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1245000249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25101 THE OLD RD",
            "city": "STEVENSON RANCH",
            "state": "CA",
            "postal_code": "913812206",
            "telephone_number": "323-538-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25101 THE OLD RD",
            "city": "STEVENSON RANCH",
            "state": "CA",
            "postal_code": "913812206",
            "telephone_number": "323-538-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAWLESS SKIN IV HYDRATION MED SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "323-538-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP,MSN,CNL,RN"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flawless Skin IV Hydration Med Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Stevenson Ranch, CA
• Infusion Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.