Organization Active NPI

Durango Dermatology and Dermatologic Surgery LLC

  • Dermatology Physician
  • Durango, CO
National Provider Identifier
1497811160
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DURANGO DERMATOLOGY AND DERMATOLOGIC SURGERY LLC
Practice address
523 S Camino del Rio
Suite B
Durango, CO 81303-6853
Phone
(970) 247-1970
Fax
(970) 259-1668
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Mark Gaughan, MDNPI 1790792851
Title
Owner
Phone
(970) 247-1970

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

523 S Camino del Rio
Suite B
Durango, CO 81303-6853

Mailing address

PO Box 2299
Durango, CO 81302-2299

Other practice location 1

72 Suttle St Unit L
Durango, CO 81303-6829
Phone (970) 247-1970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050304000492 CO Part B Supplier - Clinic/Group Practice 1153375902 Receives reassigned benefits from 11 practitioners
Practice locations: Durango, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0684336Durango Dermatology & Dermatologic Surgery PLLC523 S Camino del Rio Suite B, Durango, CO 81303ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Locations

523 S Camino del Rio
Ste B
Durango, CO 81303
Phone (970) 247-1970

523 S Camino del Rio
Durango, CO 81303
Phone (970) 247-1970

Practitioners & affiliated clinicians

Practitioners 11

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1497811160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2299",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813022299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S CAMINO DEL RIO",
            "address_2": "SUITE B",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036853",
            "telephone_number": "970-247-1970",
            "fax_number": "970-259-1668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 Suttle St Unit L",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813036829",
            "country_code": "US",
            "telephone_number": "970-247-1970",
            "fax_number": "970-259-1668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DURANGO DERMATOLOGY AND DERMATOLOGIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "GAUGHAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-247-1970",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.