Active NPI
Paul Robert Love, M.D.
- Dermatology Physician
- Mesa, AZ
National Provider Identifier
1245205590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 16638
- Practice address
- 1520 S Dobson Rd
Suite 320
Mesa, AZ 85202-4725 - Phone
- (480) 844-0866
- NPI assigned
- Feb 21, 2006
- Last updated
- Aug 9, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 16638 | AZ | Primary |
Addresses
Primary practice location
1520 S Dobson Rd
Suite 320
Mesa, AZ 85202-4725
Mailing address
1520 S Dobson Rd
Suite 320
Mesa, AZ 85202-4725
Phone (480) 844-0866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051117000694 | AZ | Practitioner - Dermatology | 2860411956 | Practice locations: Mesa, AZ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16638 | AZ | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1245205590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 S DOBSON RD",
"address_2": "SUITE 320",
"city": "MESA",
"state": "AZ",
"postal_code": "852024725",
"telephone_number": "480-844-0866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 S DOBSON RD",
"address_2": "SUITE 320",
"city": "MESA",
"state": "AZ",
"postal_code": "852024725",
"telephone_number": "480-844-0866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE",
"first_name": "PAUL",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "AZ",
"license": "16638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.