Skin PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKIN PC

Practice address

1935 E Military Ave
Fremont, NE 68025-5489

Phone

(402) 727-7979

Fax

(402) 727-9306

NPI assigned

Jun 15, 2015

Organization subpart

No

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

Authorized official

Name

Chad Hillyer, PA-C

Title

Owner

Phone

(402) 727-7979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Skin PC

  dba Skin Dermatology & Aesthetics

  • Dermatology Physician
  • Elkhorn, NE
  • NPI 1134410764

  O20110614000400

  Same enrollment

Practitioners 1

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

• Doralia Yanely Flores, FNP

  • Nurse Practitioner
  • Fremont, NE
  • NPI 1629676044
  NPD

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1801277801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 E MILITARY AVE",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255489",
            "telephone_number": "402-727-7979",
            "fax_number": "402-727-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 E MILITARY AVE",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255489",
            "telephone_number": "402-727-7979",
            "fax_number": "402-727-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "HILLYER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-727-7979",
        "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": []
}

• Lawrence Simbro
• Lisa Simonsen
• Jada Simpson, ATC, LAT
• Rachel Claire Sinley, R.D.
• Skin Envy Dermatology
• Sleep Center of Fremont, LLC.
• Jennifer Small
• Kelsea Small
• Leah Smeal
• Cynthia Ann Smith

• Dermatology Physician in Fremont, NE
• Providers in Fremont, NE by specialty
• Dermatology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.