Organization Active NPI

Exclusively Skin LLC

  • Family Medicine Physician
  • Garfield Heights, OH
National Provider Identifier
1891204285
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34007796 Issued in OH
Legal business name
EXCLUSIVELY SKIN LLC
Practice address
9565 Midwest Ave Ste C
Garfield Heights, OH 44125-2421
Phone
(216) 508-6500
Fax
(216) 508-6501
NPI assigned
Sep 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Dr. Tracy Lynette Ringo, DONPI 1649231804
Title
Owner/Physician
Phone
(216) 508-6500

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 34007796 OH Primary

Addresses

Primary practice location

9565 Midwest Ave Ste C
Garfield Heights, OH 44125-2421

Mailing address

9565 Midwest Ave Ste C
Garfield Heights, OH 44125-2421
Phone (216) 508-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180108001394 OH Part B Supplier - Clinic/Group Practice 5991064479 Receives reassigned benefits from 1 practitioner
Practice locations: Garfield HTS, OH

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
36D2143523Exclusively Skin, LLC9565 Midwest Avenue, Suite C, Garfield Heights, OH 44125Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory

Locations

9565 Midwest Ave
Ste C
Garfield Heights, OH 44125
Phone (216) 508-6500

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": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1891204285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9565 MIDWEST AVE STE C",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252421",
            "telephone_number": "216-508-6500",
            "fax_number": "216-508-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9565 MIDWEST AVE STE C",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252421",
            "telephone_number": "216-508-6500",
            "fax_number": "216-508-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCLUSIVELY SKIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "RINGO",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "216-508-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.