Academy Dermatology PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

24691 Issued in CO

Legal business name

ACADEMY DERMATOLOGY PC

Practice address

3615 Hill Cir
Colorado Springs, CO 80904-1076

Phone

(719) 590-1800

Fax

(719) 590-1858

NPI assigned

May 29, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ronald A Johnson, M.D.

Title

President

Phone

(719) 590-1800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1194162313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3246 CENTENNIAL BLVD # 112",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074077",
            "telephone_number": "719-590-1800",
            "fax_number": "719-590-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 HILL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809041076",
            "telephone_number": "719-590-1800",
            "fax_number": "719-590-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-590-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CO",
            "license": "24691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Medical Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.