Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

17666 Issued in NE

Legal business name

DERMATOLOGY PC

Practice address

404 W 39TH St
Kearney, NE 68845-2806

Phone

(308) 865-2331

Fax

(308) 865-2883

NPI assigned

Jul 12, 2007

Reactivated

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

David N Kingsley, MDNPI 1366452344

Title

President Physician

Phone

(308) 865-2331

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Norval Kingsley, M.D.

  • Specialist
  • Kearney, NE
  • NPI 1366452344
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1396944286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W 39TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452806",
            "telephone_number": "308-865-2331",
            "fax_number": "308-865-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W 39TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452806",
            "telephone_number": "308-865-2331",
            "fax_number": "308-865-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-12-17",
        "deactivation_date": "2007-11-05",
        "reactivation_date": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "KINGSLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "308-865-2331",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NE",
            "license": "17666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Dennis
• Jodi Dennison
• Tiffanie Dennison
• Ashlea Denton
• Derek Schweitzer Counseling, LLC
• Jenna N. Derr, M.D.
• Anna Katrin Desalvo, PT, DPT
• Alan Deterding
• Bailey J Devall, SLP
• Kelly L Devorss

• Dermatology Physician in Kearney, NE
• Providers in Kearney, NE by specialty
• Dermatology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.