Premier Dermatology Services PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PREMIER DERMATOLOGY SERVICES PLLC

Practice address

901 SE Plaza Ave Ste 5
Bentonville, AR 72712-5473

Phone

(479) 273-3376

Fax

(479) 273-3468

NPI assigned

Apr 15, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Sara Fast

Title

Practice Director

Phone

(479) 876-8501

Specialties & licenses 1

Addresses

Other names 1

• Premier Dermatology & Aesthetics Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

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 4

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

• Mildred Murphy Clifton, M.D.

  • Dermatology Physician
  • Bentonville, AR
  • NPI 1679521405
  Medicare reassignment Care Compare group NPD
• Cheri Caroline Cunningham, M.D

  • Dermatology Physician
  • Bentonville, AR
  • NPI 1326492869
  Medicare reassignment Care Compare group NPD
• Mimi Henderson Hill, PA-C

  • Medical Physician Assistant
  • Bentonville, AR
  • NPI 1699365106
  Medicare reassignment Care Compare group
• Kara Jo Richardson, P.A.

  • Physician Assistant
  • Bentonville, AR
  • NPI 1225200546
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1154117463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SE PLAZA AVE STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125473",
            "telephone_number": "479-273-3376",
            "fax_number": "479-273-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SE PLAZA AVE STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125473",
            "telephone_number": "479-273-3376",
            "fax_number": "479-273-3468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5691 Gateway Ave,  Suite D",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "72762",
            "country_code": "US",
            "telephone_number": "479-273-3376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1702 SE 8th St Ste 10",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727122891",
            "country_code": "US",
            "telephone_number": "479-273-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "FAST",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "479-876-8501",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• McKenzie Powlison
• Ashton Pratt, OTR/L
• Preferred Family Healthcare Inc
• Premier Aesthetics, PLLC
• Premier Dermatology & Skin Renewal Center
• Premiere Physical Therapy and Sports Rehab LLC
• Prevention Plus, Inc.
• Chelsea Price
• Hillary Beth Price, LPC
• Sydney Gabrielle Price

• Dermatology Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Dermatology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.