The Skin Group PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

THE SKIN GROUP PLLC

Doing business as

The Skin Group PLLC

Practice address

2307 River Rd Ste 101
Louisville, KY 40206-5000

Phone

(503) 583-6647

NPI assigned

Jan 9, 2024

Last updated

Jan 9, 2024By 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

Tonya Winnett

Title

Office Manager

Phone

(502) 583-6647

Specialties & licenses 2

Addresses

Other names 1

• The Skin Group PLLC Doing business as

Locations

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1346010469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 RIVER RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402065000",
            "telephone_number": "502-583-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 RIVER RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402065000",
            "telephone_number": "503-583-6647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1868 W Hebron Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401657481",
            "country_code": "US",
            "telephone_number": "502-583-6647 x103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE SKIN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "WINNETT",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-583-6647"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Skin Group PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.