Organization Active NPI

Skin Invy Hydration and Wellness PLLC

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1740150507
Registry record updated Aug 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SKIN INVY HYDRATION AND WELLNESS PLLC
Practice address
1981 J N Pease PL Ste 103
Charlotte, NC 28262-4529
Phone
(980) 369-6902
Fax
(980) 406-0185
NPI assigned
Nov 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2026

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

Authorized official

Name
Mrs. Vanessa Marie Madden-Gilyard, NPNPI 1639500481
Title
Owner/Ceo
Phone
(980) 433-0517

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1981 J N Pease PL Ste 103
Charlotte, NC 28262-4529

Mailing address

10421 Kempsford Dr
Charlotte, NC 28262-2718
Phone (980) 433-0517

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260311002563 NC Part B Supplier - Clinic/Group Practice 2062995715 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

10130 Mallard Creek Rd
Ste 310
Charlotte, NC 28262
Phone (980) 406-0185

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": "1762473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786752000000",
    "number": "1740150507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10421 KEMPSFORD DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622718",
            "telephone_number": "980-433-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 J N PEASE PL STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624529",
            "telephone_number": "980-369-6902",
            "fax_number": "980-406-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN INVY HYDRATION AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-07",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A",
        "authorized_official_last_name": "MADDEN-GILYARD",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "980-433-0517",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2026; 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.