Advanced Dermatology and Skin Cancer Center, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ADVANCED DERMATOLOGY AND SKIN CANCER CENTER, PA

Practice address

2735 Pembrook PL
Manhattan, KS 66502-7482

Phone

(785) 537-4990

Fax

(785) 537-1938

NPI assigned

Feb 23, 2006

Organization subpart

No

Name

John R Adams, M.D.NPI 1891798245

Title

President

Phone

(785) 537-4990

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Raymond Adams, MD

  • MOHS-Micrographic Surgery Physician
  • Manhattan, KS
  • NPI 1891798245

  KS, NE

  Medicare reassignment Care Compare group Authorized official
• Alayna Law, PA

  • Physician Assistant
  • Lenexa, KS
  • NPI 1821881434

  KS

  Medicare reassignment Care Compare group NPD
• Jacqueline Marin, PAC

  • Physician Assistant
  • Wichita, KS
  • NPI 1770275190

  KS

  Medicare reassignment Care Compare group
• Alyssa Bengtson, PA

  • Physician Assistant
  • Grand Island, NE
  • NPI 1891222691

  NE

  Medicare reassignment Care Compare group
• Alisha Nicole Lautenschlager, PA-C

  • Physician Assistant
  • Grand Island, NE
  • NPI 1790933711

  NE

  Medicare reassignment Care Compare group
• Tyler Lufholm, APRN

  • Family Nurse Practitioner
  • Emporia, KS
  • NPI 1609468396
  NPD
• Joshua Nicholas Schell, APRN

  • Family Nurse Practitioner
  • Manhattan, KS
  • NPI 1174102719
  NPD
• James Eugene Hicks, ARNP

  • Family Nurse Practitioner
  • Manhattan, KS
  • NPI 1316940752
  NPD (past)
• John B Setterstrom, DC

  • Chiropractor
  • Emporia, KS
  • NPI 1861565442
  NPD (past)

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in KS, NE2 enrollments

Enrollment records 2

Locations

• Emporia Dermatology and Skin Cancer Center LLC Other name
• Premier Dermatology & Mohs Surgery Center Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 7, 2023.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1124094867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 PEMBROOK PLACE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "66502",
            "telephone_number": "785-537-4990",
            "fax_number": "785-537-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 PEMBROOK PL",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665027482",
            "telephone_number": "785-537-4990",
            "fax_number": "785-537-1938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 W 13th St",
            "address_purpose": "LOCATION",
            "city": "Ottawa",
            "state": "KS",
            "postal_code": "660673545",
            "country_code": "US",
            "telephone_number": "785-521-7111",
            "fax_number": "620-208-9335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "747 N Burlington Ave Ste 312",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689014478",
            "country_code": "US",
            "telephone_number": "402-462-4872",
            "fax_number": "402-484-6253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 N Webb Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688033325",
            "country_code": "US",
            "telephone_number": "308-384-0133",
            "fax_number": "402-484-6253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Elmhurst Blvd",
            "address_purpose": "LOCATION",
            "city": "Salina",
            "state": "KS",
            "postal_code": "674017403",
            "country_code": "US",
            "telephone_number": "785-376-6400",
            "fax_number": "785-914-5054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2509 W 18th Ave",
            "address_purpose": "LOCATION",
            "city": "Emporia",
            "state": "KS",
            "postal_code": "668016105",
            "country_code": "US",
            "telephone_number": "620-341-9335",
            "fax_number": "620-208-9335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2908 W 39th St Ste D",
            "address_purpose": "LOCATION",
            "city": "Kearney",
            "state": "NE",
            "postal_code": "688451245",
            "country_code": "US",
            "telephone_number": "370-270-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY AND SKIN CANCER CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-537-4990",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emporia Dermatology and Skin Cancer Center LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Premier Dermatology & Mohs Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Keturah Adams
• Marianne Adams, LSCSW
• Advanced Audiology Inc
• Advanced Audiology Inc
• Advanced Dental Arts
• Advisors Medical PC
• Isabel Aerni
• Ahc Chiropractic Group, P.a.
• Colby Charles Akins
• Ethel Bitoh Akongnui, PMHNP-BC

• All providers in Manhattan, KS
• Dermatology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.