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INTEGRATED SKIN INSTITUTE PLLC
NPI 1770351041
Dermatology in Lebanon, TN

Active since December 18, 2023CLIA Certified · 5 labs
1424 W BADDOUR PKWY STE G, LEBANON, TN 37087(615) 314-1699(615) 622-8905 Get Directions Write a Review

NPPES record last updated: April 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Integrated Skin Institute Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTEGRATED SKIN INSTITUTE PLLC (NPI 1770351041) is a healthcare organization registered as a dermatology in Lebanon, Tennessee and active in the NPI registry since December 2023. The organization holds 5 active CLIA laboratory certificates and lists Tejaswi V Mudigonda, Ceo, as its authorized official.

NPPES Registry Identity

NPI1770351041
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED SKIN INSTITUTE PLLC
Location Address1424 W BADDOUR PKWY STE GLebanon, TN 37087-2685
Mailing Address1424 W Baddour Pkwy Ste GLebanon, TN 37087-2685 · (615) 314-1699
Phone(615) 314-1699
Fax(615) 622-8905
Organization SubpartNo
Authorized OfficialTejaswi V MudigondaCeo · (551) 208-3090
Enumeration DateDecember 18, 2023
Last NPPES UpdateApril 7, 2024
NPPES CertifiedApril 7, 2024
✔ NPI 1770351041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
Also ListedPlastic SurgeryTaxonomy 208200000X
1424 W BADDOUR PKWY STE G, Lebanon, TN 37087
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 44D2292801

Integrated Skin Institute · Lebanon, TN
Active · expires Aug 25, 2026
CLIA Number44D2292801
Laboratory TypePhysician Office
Certificate Effective DateAugust 26, 2024
Certificate Expiration DateAugust 25, 2026
Laboratory DirectorDr. Tejaswi V. Mudigonda
Laboratory Phone(615) 314-1699
Laboratory LocationIntegrated Skin Institute1424 West Baddour Pkwy , Suite G, Lebanon, TN 37087
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2337725

Integrated Skin Institute · Nashville, TN
Active · expires May 10, 2028
CLIA Number44D2337725
Laboratory TypePhysician Office
Certificate Effective DateMay 11, 2026
Certificate Expiration DateMay 10, 2028
Laboratory DirectorDr. Tejaswi V. Mudigonda
Laboratory Phone(615) 314-1699
Laboratory LocationIntegrated Skin Institute1900 Patterson Street, Suite 201, Nashville, TN 37203
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2335342

Integrated Skin Institute, PLLC · Dickson, TN
Active · expires Apr 19, 2028
CLIA Number44D2335342
Laboratory TypePhysician Office
Certificate Effective DateApril 20, 2026
Certificate Expiration DateApril 19, 2028
Laboratory DirectorDr. Tejaswi V. Mudigonda
Laboratory Phone(615) 314-1699
Laboratory LocationIntegrated Skin Institute, PLLC10101 Ramsey Way, Suite A, Dickson, TN 37055
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2252291

Integrated Skin Institute Dba Integrated Skin Institute · Gallatin, TN
Active · expires Oct 27, 2027
CLIA Number44D2252291
Laboratory TypePhysician Office
Certificate Effective DateOctober 28, 2025
Certificate Expiration DateOctober 27, 2027
Laboratory DirectorDr. Tejaswi V. Mudigonda
Laboratory Phone(615) 314-1699
Laboratory LocationIntegrated Skin Institute Dba Integrated Skin Institute1630 Nashville Pike Suite 200, Gallatin, TN 37066
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2327558

Integrated Skin Institute Dba Integrated Skin Institute · White House, TN
Active · expires Jul 23, 2027
CLIA Number44D2327558
Laboratory TypePhysician Office
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorDr. Tejaswi V. Mudigonda
Laboratory Phone(615) 314-1699
Laboratory LocationIntegrated Skin Institute Dba Integrated Skin Institute491 N Sage Rd N, Suite 300, White House, TN 37188
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Integrated Skin Institute PLLC's NPI number?

The NPI number for Integrated Skin Institute PLLC is 1770351041. It was assigned to this organization in the NPPES registry on December 18, 2023.

Where is Integrated Skin Institute PLLC located?

Integrated Skin Institute PLLC is located at 1424 W Baddour Pkwy Ste G, Lebanon, TN 37087. The listed phone number is (615) 314-1699.

What is Integrated Skin Institute PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Integrated Skin Institute PLLC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Integrated Skin Institute PLLC was last updated on April 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.