NPIMap

Organization Active NPI

Rocky Mountain Dermatology Inc

  • Dermatology Physician
  • North Logan, UT
National Provider Identifier
1154527372
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
295172-1205 Issued in UT
Legal business name
ROCKY MOUNTAIN DERMATOLOGY INC
Practice address
1760 N 200 E Ste 101
North Logan, UT 84341
Phone
(435) 787-0560
Fax
(435) 752-4673
NPI assigned
Jun 25, 2007
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Authorized official

Name
Robert P Young, M.D.NPI 1013910744
Title
Owner
Phone
(435) 787-0560

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 295172-1205 UT Primary
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NI0002X 295172-1205 UT
Pediatric Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NP0225X 295172-1205 UT
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X 295172-1205 UT

Addresses

Primary practice location

1760 N 200 E Ste 101
North Logan, UT 84341

Mailing address

1760 N 200 E Ste 101
North Logan, UT 84341-1202
Phone (435) 787-0560

Other practice location 1

984 S 500 W Ste 4
Brigham City, UT 84302-4712
Phone (801) 827-9100

Other practice location 2

5748 Adams Ave Pkwy Ste B
Washington Terrace, UT 84405-6947
Phone (801) 827-9100

Other practice location 3

1920 W 250 N Ste 17And18
Marriott Slaterville, UT 84404-9233
Phone (801) 827-9100

Other practice location 4

82 S 1100 E Ste 301
Salt Lake City, UT 84102-1890
Phone (801) 827-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080318000363 UT Part B Supplier - Clinic/Group Practice 6002992906 Receives reassigned benefits from 18 practitioners
Practice locations: Brigham City, UT; Marriott Slaterville, UT; North Logan, UT; Ogden, UT; Tremonton, UT

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0948038Rocky Mountain Dermatology1760 North 200 East Suite 101, North Logan, UT 84341ComplianceSep 30, 2026
46D1066021Rocky Mountain Dermatology5748 S Adams Ave Parkway, Suite B, Washington Terrace, UT 84405ComplianceAug 12, 2027

National Provider Directory

National Provider Directory

Locations

984 S 500 W
Ste 4
Brigham City, UT 84302
Phone (435) 695-2273

1760 N 200 E
Ste 101
North Logan, UT 84341
Phone (435) 787-0560

5748 S 500 E
#B
Ogden, UT 84405
Phone (801) 827-9100

5748 S 500 E
Ste B
Ogden, UT 84405

5748 Adams Avenue Pkwy
Ste B
Washington Terrace, UT 84405
Phone (801) 827-9100

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1154527372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 N 200 E STE 101",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411202",
            "telephone_number": "435-787-0560",
            "fax_number": "435-752-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 N 200 E STE 101",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-787-0560",
            "fax_number": "435-752-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "984 S 500 W Ste 4",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843024712",
            "country_code": "US",
            "telephone_number": "801-827-9100",
            "fax_number": "801-827-9110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5748 Adams Ave Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Washington Terrace",
            "state": "UT",
            "postal_code": "844056947",
            "country_code": "US",
            "telephone_number": "801-827-9100",
            "fax_number": "801-827-9110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1920 W 250 N Ste 17And18",
            "address_purpose": "LOCATION",
            "city": "Marriott Slaterville",
            "state": "UT",
            "postal_code": "844049233",
            "country_code": "US",
            "telephone_number": "801-827-9100",
            "fax_number": "385-264-0660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "82 S 1100 E Ste 301",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841021890",
            "country_code": "US",
            "telephone_number": "801-827-9100",
            "fax_number": "385-264-0660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-787-0560",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "UT",
            "license": "295172-1205",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "UT",
            "license": "295172-1205",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "UT",
            "license": "295172-1205",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "UT",
            "license": "295172-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.