Organization Active NPI

TS Dermatology, PLLC

  • Dermatology Physician
  • Coralville, IA
National Provider Identifier
1194027367
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
31541 Issued in IA
Legal business name
TS DERMATOLOGY, PLLC
Practice address
1100 6TH St
Suite 202
Coralville, IA 52241-1755
Phone
(319) 337-4566
Fax
(319) 337-4766
NPI assigned
Nov 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Dr. Kristi J Robson, M.D.NPI 1730128653
Title
Partner
Phone
(319) 337-4566

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 31541 IA Primary

Addresses

Primary practice location

1100 6TH St
Suite 202
Coralville, IA 52241-1755

Mailing address

1100 6TH St
Suite 202
Coralville, IA 52241-1755
Phone (319) 337-4566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101223000070 IA Part B Supplier - Clinic/Group Practice 2264620822 Receives reassigned benefits from 7 practitioners
Practice locations: Coralville, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1194027367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 6TH ST",
            "address_2": "SUITE 202",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411755",
            "telephone_number": "319-337-4566",
            "fax_number": "319-337-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 6TH ST",
            "address_2": "SUITE 202",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411755",
            "telephone_number": "319-337-4566",
            "fax_number": "319-337-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TS DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "ROBSON",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "319-337-4566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IA",
            "license": "31541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.