Organization Active NPI

Beautiful Skin LLC

  • Surgery Physician
  • Hailey, ID
National Provider Identifier
1255979480
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BEAUTIFUL SKIN LLC
Practice address
315 S River St
Hailey, ID 83333-8426
Phone
(208) 788-7700
Fax
(208) 788-3100
NPI assigned
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Dr. Thomas F Crais, MDNPI 1073668042
Title
Owner
Phone
(208) 788-7700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

315 S River St
Hailey, ID 83333-8426

Mailing address

315 S River St
Hailey, ID 83333-8426
Phone (208) 788-7700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191211002973 ID Part B Supplier - Clinic/Group Practice 2466885082 Receives reassigned benefits from 1 practitioner
Practice locations: Hailey, ID

National Provider Directory

National Provider Directory

Locations

315 S River St
Hailey, ID 83333
Phone (208) 788-1880

Practitioners & affiliated clinicians

Practitioners 1

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": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1255979480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S RIVER ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338426",
            "telephone_number": "208-788-7700",
            "fax_number": "208-788-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S RIVER ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338426",
            "telephone_number": "208-788-7700",
            "fax_number": "208-788-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL SKIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "CRAIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-788-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hailey, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.