Active NPI
Dermatology and Dermatologic Surgery Center, PC
- Dermatology Physician
- Clive, IA
National Provider Identifier
1285792788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- DERMATOLOGY AND DERMATOLOGIC SURGERY CENTER, PC
- Practice address
- 8131 University Blvd
Clive, IA 50325-1123 - Phone
- (515) 225-8180
- Fax
- (515) 225-2041
- NPI assigned
- Dec 5, 2006
- Last updated
- Apr 16, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Dee Marie Knoke
- Title
- Office Manager
- Phone
- (515) 225-8180
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | IA | Primary |
Addresses
Primary practice location
8131 University Blvd
Clive, IA 50325-1123
Mailing address
8131 University Blvd
Clive, IA 50325-1123
Phone (515) 225-8180
National Provider Directory
National Provider DirectoryLocations
1610 W Townline St
Creston, IA 50801
Phone (641) 782-2131
8131 University Blvd
Des Moines, IA 50325
Phone (515) 225-8180
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.
-
- Family Nurse Practitioner
- Newton, IA
- NPI 1063447712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1397606400000",
"number": "1285792788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8131 UNIVERSITY BLVD",
"city": "CLIVE",
"state": "IA",
"postal_code": "503251123",
"telephone_number": "515-225-8180",
"fax_number": "515-225-2041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8131 UNIVERSITY BLVD",
"city": "CLIVE",
"state": "IA",
"postal_code": "503251123",
"telephone_number": "515-225-8180",
"fax_number": "515-225-2041"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DERMATOLOGY AND DERMATOLOGIC SURGERY CENTER, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-05",
"last_updated": "2014-04-16",
"status": "A",
"authorized_official_last_name": "KNOKE",
"authorized_official_first_name": "DEE",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "515-225-8180",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "IA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.