Organization Active NPI

Justskin

  • Dermatology Physician
  • Antioch, TN
National Provider Identifier
1457042178
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JUSTSKIN
Practice address
4071 Cane Ridge Pkwy Ste 208
Antioch, TN 37013-2971
Phone
(615) 669-2393
NPI assigned
May 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Marleen Yosef, PA-CNPI 1972110831
Title
President
Phone
(615) 609-3417

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4071 Cane Ridge Pkwy Ste 208
Antioch, TN 37013-2971

Mailing address

4071 Cane Ridge Pkwy Ste 208
Antioch, TN 37013-2971
Phone (615) 669-2393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230725002006 TN Part B Supplier - Clinic/Group Practice 6103287016 Receives reassigned benefits from 1 practitioner
Practice locations: Antioch, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2284050Justskin4071 Cane Ridge Pkwy Ste 208, Antioch, TN 37013Certificate of waiverJun 15, 2027

National Provider Directory

National Provider Directory

Locations

4071 Cane Ridge Pkwy
Ste 208
Antioch, TN 37013
Phone (615) 669-2393

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1457042178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 CANE RIDGE PKWY STE 208",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132971",
            "telephone_number": "615-669-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 CANE RIDGE PKWY STE 208",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132971",
            "telephone_number": "615-669-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTSKIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "YOSEF",
        "authorized_official_first_name": "MARLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-609-3417",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.