NPIMap

Organization Active NPI

The Dermatology Clinic PA

  • Dermatology Physician
  • Hot Springs, AR
National Provider Identifier
1225020852
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
THE DERMATOLOGY CLINIC PA
Practice address
3633 Central Ave
Ste N
Hot Springs, AR 71913-6404
Phone
(501) 623-6100
Fax
(501) 623-6187
NPI assigned
Aug 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Mr. Adam S Stibich, MDNPI 1093715047
Title
Owner / Provider / Physician
Phone
(501) 623-6100

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 Primary

Addresses

Primary practice location

3633 Central Ave
Ste N
Hot Springs, AR 71913-6404

Mailing address

3633 Central Ave
Ste N
Hot Springs, AR 71913-6404
Phone (501) 623-6100

Other identifiers 1

IdentifierTypeStateIssuer
120956002MedicaidAR

Other names 1

  • The Stough Clinic of Dermatology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716000606 AR Part B Supplier - Clinic/Group Practice 4789663345 Receives reassigned benefits from 10 practitioners
Practice locations: Hot Springs, AR; Hot Springs VLG, AR; Malvern, AR; Texarkana, AR

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
04D0696892Dermatology Clinic PA, the3633 Central Avenue, Suite N, Hot Springs, AR 71913ComplianceMar 29, 2027

National Provider Directory

National Provider Directory

Locations

610 W Commerce Dr
Ste 3
Bryant, AR 72022

3633 Central Ave
Ste N
Hot Springs National Park, AR 71913
Phone (501) 623-6100

101 Plaza Carmona Pl
Hot Springs Village, AR 71909
Phone (501) 623-6100

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 10

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": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1225020852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 CENTRAL AVE",
            "address_2": "STE N",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136404",
            "telephone_number": "501-623-6100",
            "fax_number": "501-623-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 CENTRAL AVE",
            "address_2": "STE N",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136404",
            "telephone_number": "501-623-6100",
            "fax_number": "501-623-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DERMATOLOGY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "STIBICH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER / PROVIDER / PHYSICIAN",
        "authorized_official_telephone_number": "501-623-6100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120956002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Stough Clinic of Dermatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.