J. Robert West, M.D., Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

40312 Issued in AZ

Legal business name

J. ROBERT WEST, M.D., INC

Practice address

1729 N Trekell Rd Ste 124
Casa Grande, AZ 85122-2215

Phone

(520) 421-7100

Fax

(520) 421-1300

NPI assigned

Aug 17, 2009

Organization subpart

No

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

Authorized official

Name

Lucius Blanchard, M.D.

Title

Owner/Physician

Phone

(702) 360-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• West Dermatology of Arizona Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• J. Robert West, M.D., Inc

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1114567997

  O20090813000213

  Same enrollment
• J Robert West, M.D., Inc

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788

  O20090813000213

  Same enrollment

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• J. Robert West, M.D., Inc

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1114567997
  NPPES parent name

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1407088081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 PARK CENTRAL DR STE 1210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511522",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 N TREKELL RD STE 124",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222215",
            "telephone_number": "520-421-7100",
            "fax_number": "520-421-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. ROBERT WEST, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "LUCIUS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "702-360-2100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "40312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE 08/01/09",
            "identifier": "DP3049",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Dermatology of Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.