Vernon T Mackey PC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

3535 Issued in AZ

Legal business name

VERNON T MACKEY PC

Doing business as

Advanced Desert Dermatology

Practice address

9191 W Thunderbird Rd
Suite D-101
Peoria, AZ 85381-4270

Phone

(623) 977-6700

Fax

(623) 977-6771

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vernon T Mackey, D.O.NPI 1821046772

Title

Physician

Phone

(623) 977-6700

Specialties & licenses 1

Addresses

Other names 1

• Advanced Desert Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Tax ID family

Advanced Desert Dermatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vernon T Mackey, PC

  dba Advanced Desert Dermatology

  • Clinical & Laboratory Dermatological Immunology Physician
  • Peoria, AZ
  • NPI 1003204975
  NPD tax ID

Practitioners 3

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

• Vernon Thomas Mackey, D.O.

  • MOHS-Micrographic Surgery Physician
  • Peoria, AZ
  • NPI 1821046772
  Medicare reassignment Authorized official
• Madison Green, PA-C

  • Physician Assistant
  • Peoria, AZ
  • NPI 1770329070
  Medicare reassignment
• Brandon J Mackey, D.O.

  • Clinical & Laboratory Dermatological Immunology Physician
  • Peoria, AZ
  • NPI 1477081149
  Medicare reassignment

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1396959417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 W THUNDERBIRD RD",
            "address_2": "SUITE D-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814270",
            "telephone_number": "623-977-6700",
            "fax_number": "623-977-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 W THUNDERBIRD RD",
            "address_2": "SUITE D-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814270",
            "telephone_number": "623-977-6700",
            "fax_number": "623-977-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON T MACKEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "623-977-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "3535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Desert Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Desert Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Renee Venema, PA-C
• Mickenzi Venhaus
• Ventana Family Dentistry LLC
• Stephanie Vergara-Bermudez, LPN
• Vishal Verma, M.D
• Vernon T Mackey, PC (Advanced Desert Dermatology)
• Eunice Vesa
• Vet Evals
• VHS of Arrowhead, Inc. (Abrazo Peoria Emergency Center)
• Victor Cosmetic and Family Dentistry LLC

• Procedural Dermatology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Procedural Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.