Lake Loveland Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LAKE LOVELAND DERMATOLOGY PC

Practice address

1683 Main St
Windsor, CO 80550-7921

Phone

(970) 667-3116

Fax

(970) 669-0159

NPI assigned

Nov 5, 2020

Last updated

Jan 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin John Mott, MDNPI 1295776201

Title

Owner

Phone

(303) 569-7700

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Sterling, CO
  • NPI 1437750304

  O20040923001237

  Same enrollment
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Loveland, CO
  • NPI 1679646582

  O20040923001237

  Same enrollment
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1700487675

  O20040923001237

  Same enrollment

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Skin PC

  • MOHS-Micrographic Surgery Physician
  • Winter Park, CO
  • NPI 1710588447

  Member Of

  NPD member

Locations

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.

• Kevin John Mott, MD

  • MOHS-Micrographic Surgery Physician
  • Loveland, CO
  • NPI 1295776201
  Authorized official Same address or phone
• David Joseph Seitz IV, P.A.-C.

  • Medical Physician Assistant
  • Loveland, CO
  • NPI 1235169194
  NPD
• Michaela Paige Sullivan, PA-C

  • Physician Assistant
  • Loveland, CO
  • NPI 1982308193
  NPD

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1073114948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7643",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370643",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1683 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805507921",
            "telephone_number": "970-667-3116",
            "fax_number": "970-669-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE LOVELAND DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "MOTT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-569-7700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd A Kreager, DC
• Ashley Alan Kress, PT, DPT, LSVT
• Lucie Kuhlmann, LCSW
• Olivia La, DC
• Ladybug Pediatric Occupational Therapy LLC
• Joan E. Larsen, M.S.
• Jamie Latimer
• Janell Lowman Lawlis, COTA/L
• Macaira Leahy
• Katherine Leiby, BA

• Dermatology Physician in Windsor, CO
• Providers in Windsor, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.