Organization Active NPI

Dermatology Solutions

  • Dermatology Physician
  • Kennewick, WA
National Provider Identifier
1417599374
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY SOLUTIONS
Practice address
4309 W 27TH PL Ste 301
Kennewick, WA 99338-2909
Phone
(509) 303-3428
Fax
(509) 436-7271
NPI assigned
Oct 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Christy Masterman, ARNPNPI 1841396413
Title
Owner, Nurse Practitioner
Phone
(509) 539-3698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4309 W 27TH PL Ste 301
Kennewick, WA 99338-2909

Mailing address

89825 Summit View Dr
Kennewick, WA 99338-2270
Phone (509) 303-3428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200330002461 WA Part B Supplier - Clinic/Group Practice 4082043872 Receives reassigned benefits from 5 practitioners
Practice locations: Kennewick, WA

National Provider Directory

National Provider Directory

Locations

4309 W 27th Pl
Kennewick, WA 99338

4309 W 27th Pl
Ste 301
Kennewick, WA 99338
Phone (509) 222-2231

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1417599374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89825 SUMMIT VIEW DR",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382270",
            "telephone_number": "509-303-3428",
            "fax_number": "509-436-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W 27TH PL STE 301",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382909",
            "telephone_number": "509-303-3428",
            "fax_number": "509-436-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "MASTERMAN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OWNER, NURSE PRACTITIONER",
        "authorized_official_telephone_number": "509-539-3698",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.