NPIMap

Organization Active NPI

Archway Dermatology, LLC

  • Dermatology Physician
  • Chesterfield, MO
National Provider Identifier
1366706509
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ARCHWAY DERMATOLOGY, LLC
Practice address
224 S Woods Mill Rd
Suite 570S
Chesterfield, MO 63017-3451
Phone
(314) 878-2556
Fax
(314) 275-7442
NPI assigned
Jul 3, 2012
Last updated
Jul 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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

Authorized official

Name
Alicia MillerNPI 1710969183
Title
Physician
Phone
(314) 878-2556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

224 S Woods Mill Rd
Suite 570S
Chesterfield, MO 63017-3451

Mailing address

224 S Woods Mill Rd
Suite 570S
Chesterfield, MO 63017-3451
Phone (314) 878-2556

National Provider Directory

National Provider Directory

Locations

224 S Woods Mill Rd
Ste 570S
Chesterfield, MO 63017
Phone (314) 878-2556

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1366706509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD",
            "address_2": "SUITE 570S",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173451",
            "telephone_number": "314-878-2556",
            "fax_number": "314-275-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD",
            "address_2": "SUITE 570S",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173451",
            "telephone_number": "314-878-2556",
            "fax_number": "314-275-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHWAY DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "314-878-2556"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.