NPIMap

Organization Active NPI

Dermatology & Skin Surgery Center

  • Specialist
  • Battle Creek, MI
National Provider Identifier
1083649628
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DERMATOLOGY & SKIN SURGERY CENTER
Practice address
7070 E Dr N
Battle Creek, MI 49014-8562
Phone
(269) 660-1670
Fax
(269) 660-0666
NPI assigned
Jul 12, 2006
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Dr. Donn A Latour, M.D.NPI 1427139674
Title
President
Phone
(269) 660-1670

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
Specialist 174400000X NU Primary

Addresses

Primary practice location

7070 E Dr N
Battle Creek, MI 49014-8562

Mailing address

7070 E Dr N
Battle Creek, MI 49014-8562
Phone (269) 660-1670

Other identifiers 1

IdentifierTypeStateIssuer
070A310490OtherMIBCBSM GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040416001331 MI Part B Supplier - Clinic/Group Practice 2668467838 Receives reassigned benefits from 28 practitioners
Practice locations: Saint Joseph, MI; Sturgis, MI; Kalamazoo, MI; Hillsdale, MI; Adrian, MI; Battle Creek, MI; Jackson, MI
O20170310001705 IN Part B Supplier - Clinic/Group Practice 2668467838 Receives reassigned benefits from 11 practitioners
Practice locations: Angola, IN

National Provider Directory

National Provider Directory

Locations

7070 E Dr N
Battle Creek, MI 49014
Phone (269) 660-1670

2121 Spring Arbor Rd
Jackson, MI 49203
Phone (517) 787-5350

555 W Crosstown Pkwy
Ste 101
Kalamazoo, MI 49008
Phone (269) 342-2991

2340 E Centre Ave
Ste B
Portage, MI 49002
Phone (269) 789-1670

70420 S Centerville Rd
Ste B
Sturgis, MI 49091
Phone (269) 660-1670

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1083649628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 E DR N",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490148562",
            "telephone_number": "269-660-1670",
            "fax_number": "269-660-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 E DR N",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490148562",
            "telephone_number": "269-660-1670",
            "fax_number": "269-660-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & SKIN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "LATOUR",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-660-1670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP #",
            "identifier": "070A310490",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.