Skinpath Diagnostics LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

SKINPATH DIAGNOSTICS LLC

Practice address

3000 Knight Street
BLDG 5 Suite 220
Shreveport, LA 71105

Phone

(318) 841-9526

Fax

(318) 841-9551

NPI assigned

Jan 21, 2012

Last updated

Apr 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan J Matherne, MDNPI 1528259710

Title

Medical Director

Phone

(985) 446-5888

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Ryan Joseph Matherne, MD

  • Dermatology Physician
  • Thibodaux, LA
  • NPI 1528259710
  Authorized official Same address or phone

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1306117460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 KNIGHT STREET",
            "address_2": "BLDG 5 SUITE 220",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-841-9526",
            "fax_number": "318-841-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 KNIGHT STREET",
            "address_2": "BLDG 5 SUITE 220",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-841-9526",
            "fax_number": "318-841-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINPATH DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-21",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "MATHERNE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "985-446-5888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1500615",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Skeesick & Williams, LLC
• Kelly Lee Skeesick, LPC, LMFT, NCC
• Kimberly Lynn Skidmore, M.D.
• Skin Surgery Specialists
• Robert Skinner
• Ivan Skocibusic, RT (R)
• Sky Blu Medical Transportation Service Inc
• Skyline Management Group
• Hailey Lynn Hesterman Slack
• Russell Allan Slack, CRNA

• Physiological Laboratory in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physiological Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.