Park City Dermatology. Co

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

3673151205 Issued in UT

Legal business name

PARK CITY DERMATOLOGY. CO

Doing business as

Park City Dermatology

Practice address

1790 Sun Peak Dr Ste A103
Park City, UT 84098

Phone

(435) 658-1013

Fax

(435) 658-3513

NPI assigned

Jan 8, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

PARK CITY DERMATOLOGY. COAs reported in NPPES

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

Authorized official

Name

Dr. Steven Mark Kern, MDNPI 1104814102

Title

President

Phone

(435) 658-1013

Specialties & licenses 1

Addresses

Other names 2

• Park City Dermatology Doing business as
• CENTER FOR COSMETIC DERMATOLOGY Former legal business name

Part of

Park City Dermatology Co

Locations

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.

• Steven Mark Kern, M.D.

  • Dermatology Physician
  • Park City, UT
  • NPI 1104814102
  Authorized official Same address or phone

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1316095722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 SUN PEAK DR STE A103",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986625",
            "telephone_number": "435-658-1013",
            "fax_number": "435-658-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 SUN PEAK DR STE A103",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-658-1013",
            "fax_number": "435-658-3513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Homestead Rd",
            "address_2": "Suite 30",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "UT",
            "postal_code": "840984857",
            "country_code": "US",
            "telephone_number": "435-658-1013",
            "fax_number": "435-658-3513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARK CITY DERMATOLOGY. CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK CITY DERMATOLOGY. CO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-658-1013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "UT",
            "license": "3673151205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park City Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park City Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CENTER FOR COSMETIC DERMATOLOGY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kathleen M Papi-Baker, OT
• Park City Chiropractic L.C.
• Park City Clinic Pharmacy
• Park City Dental Associates LLC
• Park City Dental Spa
• Park City Endodontics LLC
• Park City Fire Service District (Park City Ambulance)
• Park City Gynecology, LLC
• Park City Healthcare, PC (Park City Clinic)
• Park City Imaging, Inc.

• Dermatology Physician in Park City, UT
• Providers in Park City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.