Columbia Dermatology, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

107883 Issued in MO

Legal business name

COLUMBIA DERMATOLOGY, INC

Practice address

401 N Keene St
Columbia, MO 65201-6625

Phone

(573) 876-1616

Fax

(573) 876-1678

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Lindall A. Perry, M.D.

Title

President

Phone

(573) 876-1616

Specialties & licenses 2

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Abby Catherine Bradford, RN, FNP-BC

  • Family Nurse Practitioner
  • Jefferson City, MO
  • NPI 1619265196
  NPD (past)
• Angel L. Allen, M.D.

  • Dermatology Physician
  • Foley, AL
  • NPI 1780664409
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1609960509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016625",
            "telephone_number": "573-876-1616",
            "fax_number": "573-876-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016625",
            "telephone_number": "573-876-1616",
            "fax_number": "573-876-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA DERMATOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "LINDALL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-876-1616",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MO",
            "license": "107883",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "107883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Columbia Chiropractic Group LLC
• Columbia Community Birth Center
• Columbia Comprehensive Cancer Care Clinic
• Columbia Consultative Medicine
• Columbia Dentistry for Children
• Columbia Endoscopy Center, LLC
• Columbia Eye Consultants Optometry
• Columbia Eyewear
• Columbia Family Dental, LLC
• Columbia Family Focus Eyecare, LLC

• Dermatology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.