Organization Active NPI

Skin Care Clinic PLLC

  • Family Nurse Practitioner
  • Newton, IA
National Provider Identifier
1427319672
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A-076022 Issued in IA
Legal business name
SKIN CARE CLINIC PLLC
Practice address
204 N 4TH Ave E
Newton, IA 50208-3135
Phone
(641) 792-1273
NPI assigned
Jun 5, 2012
Last updated
Aug 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Authorized official

Name
Linda Sue Schilling, NP-CNPI 1063447712
Title
Owner
Phone
(515) 669-5520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X A-076022 IA Primary

Addresses

Primary practice location

204 N 4TH Ave E
Newton, IA 50208-3135

Mailing address

2213 Grand Ave
Des Moines, IA 50312-5305
Phone (515) 237-3974

Other identifiers 2

IdentifierTypeStateIssuer
1427319672MedicaidIA
1427319672OtherIABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120803000808 IA Part B Supplier - Clinic/Group Practice 4981850153 Practice locations: Newton, IA; Grinnell, IA; Atlantic, IA

National Provider Directory

National Provider Directory

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": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1427319672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125305",
            "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": "204 N 4TH AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083135",
            "telephone_number": "641-792-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "SCHILLING",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-669-5520",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-076022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427319672",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1427319672",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.