Organization Active NPI

Skin District

  • Other Specialist/Technologist
  • New York, NY
National Provider Identifier
1881420057
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Legal business name
SKIN DISTRICT
Practice address
5030 Broadway Ste 342
New York, NY 10034-1609
Phone
(407) 982-4876
NPI assigned
Sep 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Jennifer Williams
Title
Biller
Phone
(407) 982-4876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246Z00000X Primary

Addresses

Primary practice location

5030 Broadway Ste 342
New York, NY 10034-1609

Mailing address

5030 Broadway Ste 342
New York, NY 10034-1609
Phone (407) 982-4876

National Provider Directory

National Provider Directory

Locations

5030 Broadway
Ste 342
New York, NY 10034

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": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1881420057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY STE 342",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341609",
            "telephone_number": "407-982-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY STE 342",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341609",
            "telephone_number": "407-982-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "407-982-4876"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.