Organization Active NPI

Dean Derm PLLC

Doing business as Dean Dermatology & Skin Therapy

  • Dermatology Physician
  • Alexandria, LA
National Provider Identifier
1063941763
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD205038 Issued in LA
Legal business name
DEAN DERM PLLC
Doing business as
Dean Dermatology & Skin Therapy
Practice address
4615 Parliament Dr Ste 204
Alexandria, LA 71303-2759
Phone
(318) 722-7109
NPI assigned
Jun 6, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Rachel Dean, MD205038NPI 1649413881
Title
Owner
Phone
(318) 722-7109

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
Dermatology Physician 207N00000X MD205038 LA Primary

Addresses

Primary practice location

4615 Parliament Dr Ste 204
Alexandria, LA 71303-2759

Mailing address

4615 Parliament Dr Ste 204
Alexandria, LA 71303-2759
Phone (318) 722-7109

Other practice location 1

134 E 5th St
Natchitoches, LA 71457-5725
Phone (318) 722-7109

Other names 1

  • Dean Dermatology & Skin Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170830002904 LA Part B Supplier - Clinic/Group Practice 0143593913 Receives reassigned benefits from 3 practitioners
Practice locations: Alexandria, LA

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
19D2133649Dean Dermatology & Skin Therapy4615 Parliament Dr, Suite 204, Alexandria, LA 71303Certificate of waiverJul 17, 2027

National Provider Directory

National Provider Directory

Locations

4615 Parliament Dr
Ste 204
Alexandria, LA 71303
Phone (318) 321-5245

216 University Pkwy
Natchitoches, LA 71457
Phone (318) 524-8022

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063941763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 PARLIAMENT DR STE 204",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032759",
            "telephone_number": "318-722-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 PARLIAMENT DR STE 204",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032759",
            "telephone_number": "318-722-7109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Natchitoches",
            "state": "LA",
            "postal_code": "714575725",
            "country_code": "US",
            "telephone_number": "318-722-7109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEAN DERM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-722-7109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD205038"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD205038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dean Dermatology & Skin Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dean Dermatology & Skin Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.