Active NPI
Skin Specialists
- Procedural Dermatology Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- Legal business name
- SKIN SPECIALISTS
- Practice address
- 825 Nicollet Mall
Suite 1002
Minneapolis, MN 55402-2614 - Phone
- (612) 338-0711
- Fax
- (612) 332-3663
- NPI assigned
- Nov 17, 2015
- Last updated
- Sep 2, 2016
- Organization subpart
- Yes
- Parent organization
- UNITED SKIN SPECIALISTS, LTD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian D Zelickson, M.D
- Title
- Ceo
- Phone
- (952) 929-8888
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | Primary |
Addresses
Primary practice location
825 Nicollet Mall
Suite 1002
Minneapolis, MN 55402-2614
Mailing address
2 Carlson Parkway North
Suite 240
Plymouth, MN 55447-4485
Phone (763) 367-7110
National Provider Directory
National Provider Directory- Tax ID family
- United Skin Specialists LTD PC
- Part of
- United Skin Specialists LTD PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Procedural Dermatology Physician
- Richfield, MN
- NPI 1518331420
Locations
825 Nicollet Mall
Ste 1002
Minneapolis, MN 55402
Phone (612) 338-0711
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.
-
- Dermatology Physician
- Minneapolis, MN
- NPI 1336195148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447718400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1472774400000",
"number": "1629442538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CARLSON PARKWAY NORTH",
"address_2": "SUITE 240",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474485",
"telephone_number": "763-367-7110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 NICOLLET MALL",
"address_2": "SUITE 1002",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022614",
"telephone_number": "612-338-0711",
"fax_number": "612-332-3663"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SKIN SPECIALISTS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "UNITED SKIN SPECIALISTS, LTD",
"enumeration_date": "2015-11-17",
"last_updated": "2016-09-02",
"status": "A",
"authorized_official_last_name": "ZELICKSON",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "952-929-8888",
"authorized_official_credential": "M.D"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology, Procedural Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.