Skinspa LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD-42639 Issued in IA

Legal business name

SKINSPA LLC

Doing business as

Skingym by Ashley

Practice address

9350 University Ave Ste 132
West Des Moines, IA 50266-1648

Phone

(801) 870-2780

Fax

(515) 288-0122

NPI assigned

Dec 30, 2015

Organization subpart

No

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

Authorized official

Name

Ashley Van Zetten

Title

Managing Owner

Phone

(801) 870-2780

Specialties & licenses 1

Addresses

Other names 1

• Skingym by Ashley Doing business as

Locations

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1275998692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 UNIVERSITY AVE STE 132",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661648",
            "telephone_number": "515-237-3974",
            "fax_number": "515-883-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 UNIVERSITY AVE STE 132",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661648",
            "telephone_number": "801-870-2780",
            "fax_number": "515-288-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINSPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "VAN ZETTEN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "801-870-2780"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IA",
            "license": "MD-42639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skingym by Ashley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.