NPIMap

Organization Active NPI

Ubben Dermatology Clinic

  • Specialist
  • Bella Vista, AR
National Provider Identifier
1194776906
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C-8212 Issued in AR
Legal business name
UBBEN DERMATOLOGY CLINIC
Practice address
5 Cunningham Cor
Bella Vista, AR 72714-3520
Phone
(479) 855-1247
Fax
(479) 855-1249
NPI assigned
May 15, 2006
Last updated
May 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Kenneth L Ubben, M.D.NPI 1326099136
Title
Owner
Phone
(479) 855-1247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X C-8212 AR Primary

Addresses

Primary practice location

5 Cunningham Cor
Bella Vista, AR 72714-3520

Mailing address

5 Cunningham Cor
Bella Vista, AR 72714-3520
Phone (479) 855-1247

National Provider Directory

National Provider Directory

Locations

5 Cunningham Cor
Bella Vista, AR 72714
Phone (479) 855-1247

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1194776906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CUNNINGHAM COR",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143520",
            "telephone_number": "479-855-1247",
            "fax_number": "479-855-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CUNNINGHAM COR",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143520",
            "telephone_number": "479-855-1247",
            "fax_number": "479-855-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UBBEN DERMATOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "UBBEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-855-1247",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "C-8212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.