SKIN RENAISSANCE (NPI# 1962952275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962952275 |
| Entity Type | Organization |
| Organization Name | SKIN RENAISSANCE |
| Practice Address |
312 Cedar Lakes Dr Suite 103 Chesapeake VA 23322-8374 |
| Practice Telephone | 7574102833 |
| Practice Fax Number | 7578197591 |
| Mailing Telephone | 7574102833 |
| Mailing Fax Number | 7578197591 |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |
| Authorized Official Name | JULIE FOSTER TRASK (OWNER) |
| Authorized Official Telephone | 7574102833 |
| Authorized Official Credential | R.N. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 0024170014 | VA | Ambulatory Health Care Facilities |
| Street Address |
312 CEDAR LAKES DR SUITE 103 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23322-8374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033151436 | Igor Magier | Psychologist | 312 Cedar Lakes Dr, Suite 203, Chesapeake, VA 23322-8374 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154986347 | Center for Visual Surgical Excellence, LLC | Clinic/Center | 208 Carmichael Way, Chesapeake, VA 23322 | 2019-05-03 |
| 1235648213 | Sarah Nagy | Specialist/Technologist | 205 Rountree Drive, Chesapeake, VA 23322 | 2017-09-22 |
| 1629590286 | Jack Beverly Harris Jr. | Contractor | 156 Greengable Way, Chesapeake, VA 23322 | 2017-07-14 |
| 1528597911 | Sara Osborne | Speech-Language Pathologist | 404 Mike Trail, Chesapeake, VA 23322 | 2017-06-08 |
| 1194100198 | Kerry Maldiner | Marriage & Family Therapist | 501 Cedar Rd Ste 2c, Chesapeake, VA 23322 | 2015-07-21 |
| 1619361532 | Kathryn Restaino | Student in an Organized Health Care Education/Training Program | 705 Forest Mills Rd, Chesapeake, VA 23322 | 2015-03-28 |
| 1083037212 | Kenneth E. Grindlay | Dentist | 228 Mount Pleasant Rd., Chesapeake, VA 23322 | 2014-01-23 |
| 1841538006 | Karen Mcquarrie | Behavioral Analyst | 1200 Jamaica Avenue, Chesapeake, VA 23322 | 2013-01-23 |
| 1255615886 | Vera Roberts Jackson | Pharmacist | 321 Battlefield Blvd. South, Chesapeake, VA 23322 | 2011-09-30 |
| 1669754628 | Jacqueline Dungan | Pharmacist | 201 Hanbury Road E, Chesapeake, VA 23322 | 2011-09-15 |
| Find all providers in zip 23322 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1790279651 | Chesapeake Healthcare Center | Clinic/Center | 11950 Maccorkle Ave, Chesapeake, WV 25315-1135 | 2018-06-14 |
| 1487101747 | Healthyher Center for Womens Care | Clinic/Center | 2147 Old Greenbrier Rd, Chesapeake, VA 23320-2635 | 2016-09-04 |
| 1194015289 | Cox Chiropractic Wellness Center | Clinic/Center | 801 Poindexter St, Suite 219, Chesapeake, VA 23324-2358 | 2011-04-11 |
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| 1144879206 | Neurological Clinic, Sc | Clinic/Center | 7700 Little River Tpke Ste 605, Annandale, VA 22003-2400 | 2019-09-10 |
| Find all providers with the same taxonomy | ||||
| City | CHESAPEAKE |
| Zip Code | 23322 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.