Fife Dermatology PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

FIFE DERMATOLOGY PC

Doing business as

Vivda Dermatology
Vivida Dermatology

Practice address

2110 E Flamingo Rd # 213
Las Vegas, NV 89119-5190

Phone

(702) 255-6647

Fax

(702) 933-1444

NPI assigned

Jun 5, 2019

Organization subpart

No

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

Authorized official

Name

Douglas Jackson Fife, MDNPI 1225228034

Title

Physician

Phone

(702) 255-6647

Specialties & licenses 1

Addresses

Other names 2

• Vivda Dermatology Doing business as
• Vivida Dermatology Doing business as

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

CLIA laboratory certificates

Tax ID family

Fife Dermatology PC 13 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Fife Dermatology, P.C.

  • MOHS-Micrographic Surgery Physician
  • Henderson, NV
  • NPI 1821569138
  NPD tax ID
• Fife Dermatology, PC 1

  dba Surgical Dermatology and Laser Center

  • Dermatology Physician
  • Las Vegas, NV
  • NPI 1619492378
  NPD tax ID

Locations

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.

• Fife Dermatology, PC 1

  dba Surgical Dermatology and Laser Center

  • Dermatology Physician
  • Las Vegas, NV
  • NPI 1619492378
  NPPES parent name

Practitioners 1

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

• Douglas Jackson Fife, M.D.

  • Specialist
  • Las Vegas, NV
  • NPI 1225228034
  NPD (past) Authorized official

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1598323362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD # 213",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195190",
            "telephone_number": "702-255-6647",
            "fax_number": "702-933-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD # 213",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195190",
            "telephone_number": "702-255-6647",
            "fax_number": "702-933-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFE DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "FIFE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "702-255-6647",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vivda Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vivida Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanne M Fierro, RN MSN MPH FNP-C CNS
• Olg Fierro
• Nancy Linda Fierros
• Erlindo Fiesta
• Zonia Dumlao Fiesta, APRN,MSN, FNP-BC
• Fife Dermatology, P.C. (Surgical Dermatology and Laser Center)
• Fife Dermatology, PC 1 (Surgical Dermatology and Laser Center)
• Berlyn Sofi-Bella Fife
• David Callister Fife, DDS
• Douglas Jackson Fife, M.D.

• MOHS-Micrographic Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• MOHS-Micrographic Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.