Advanced Dermatology & Skin Cancer Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC

Practice address

1444 E Stearns St
Suite 11
Fayetteville, AR 72703-6243

Phone

(479) 718-7546

Fax

(479) 966-4979

NPI assigned

Sep 25, 2007

Last updated

Aug 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lance Brandon Henry, M.D.NPI 1679682520

Title

Director

Phone

(479) 856-8494

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

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.

• Lance B. Henry, M.D.

  • Dermatology Physician
  • Fayetteville, AR
  • NPI 1679682520
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan Rich, MD

  • Dermatology Physician
  • Rogers, AR
  • NPI 1578852455
  Medicare reassignment Care Compare group NPD
• Seth Michael Martin

  • MOHS-Micrographic Surgery Physician
  • Olympia, WA
  • NPI 1801355862

  AR

  Medicare reassignment Care Compare group NPD
• Ryan Crowder, PA-C

  • Physician Assistant
  • Fayetteville, AR
  • NPI 1558784728
  Medicare reassignment Care Compare group
• Jonathan David Dickson, PA-C

  • Physician Assistant
  • Fayetteville, AR
  • NPI 1487110474
  Medicare reassignment Care Compare group
• William Landon Ross, PA-C

  • Physician Assistant
  • Fayetteville, AR
  • NPI 1982172029
  Medicare reassignment Care Compare group
• Andrea L Thompson, PA-C

  • Physician Assistant
  • Fayetteville, AR
  • NPI 1508861865
  Medicare reassignment Care Compare group
• Lyndsey Whitaker, APRN

  • Family Nurse Practitioner
  • Fayetteville, AR
  • NPI 1295292332
  Medicare reassignment Care Compare group
• Cyril E Severns, MD

  • Dermatology Physician
  • Fort Smith, AR
  • NPI 1013904176
  Medicare reassignment NPD
• Nathan Merritt Johnson, M.D.

  • Dermatology Physician
  • Roanoke, VA
  • NPI 1942731674

  AR

  Medicare reassignment NPD
• Mark Franklin Naylor, MD

  • Dermatology Physician
  • Mount Vernon, IL
  • NPI 1518916386

  AR

  Medicare reassignment NPD

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1245426162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 E STEARNS ST",
            "address_2": "SUITE 11",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036243",
            "telephone_number": "479-718-7546",
            "fax_number": "479-966-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 E STEARNS ST",
            "address_2": "SUITE 11",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036243",
            "telephone_number": "479-718-7546",
            "fax_number": "479-966-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "BRANDON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "479-856-8494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny P Adkins, MD
• Tina Adkins
• Brennan Adrian
• Adult Speech and Voice Care of Northwest Arkansas, LLC
• Advanced Ambulatory Surgery Center, LLC
• Advanced Medical Specialists, PLLC
• Advanced Monitoring Services, Inc
• Aell Spencer Chiropractic Inc (The Wellness Center)
• Aftersun Psychotherapy & Healing, LLC
• Joseph Agan, CCC-SLP

• Clinic/Center in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.