Brent Loftis, DO Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

20A11845 Issued in CA

Legal business name

BRENT LOFTIS, DO INC.

Doing business as

Wine Country Dermatology

Practice address

3230 Beard Rd Ste 2
Napa, CA 94558-3659

Phone

(707) 203-2781

Fax

(707) 203-2782

NPI assigned

Oct 26, 2011

Last updated

Jul 21, 2022By 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

Dr. Brent Loftis, D.O.NPI 1639348683

Title

Owner/Physician

Phone

(707) 203-2781

Specialties & licenses 1

Addresses

Other names 1

• Wine Country Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Brent Loftis, DO

  • Dermatology Physician
  • Napa, CA
  • NPI 1639348683
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1144506833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BEARD RD STE 2",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583659",
            "telephone_number": "707-203-2781",
            "fax_number": "707-203-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 BEARD RD STE 2",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583659",
            "telephone_number": "707-203-2781",
            "fax_number": "707-203-2782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT LOFTIS, DO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LOFTIS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "707-203-2781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A11845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wine Country Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wine Country Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Napa, CA
• Providers in Napa, CA by specialty
• Dermatology Physician in California

• 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.