Summit Dermatology, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

33020 Issued in CO

Legal business name

SUMMIT DERMATOLOGY, P.C.

Practice address

8890 N Union Blvd
Suite 207
Colorado Springs, CO 80920-7799

Phone

(719) 667-0888

Fax

(719) 667-0808

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Kevin L Whaley I, M.D.NPI 1336186246

Title

Physician and Owner

Phone

(719) 667-0888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin L Whaley, MD

  • Dermatology Physician
  • Colorado Springs, CO
  • NPI 1336186246
  Medicare reassignment Care Compare group NPD Authorized official
• Jeanne Pruss Osborn, M.D.

  • Dermatology Physician
  • Colorado Springs, CO
  • NPI 1013994367
  Medicare reassignment Care Compare group NPD
• Rebecca Nicole Matz, M.D.

  • Dermatology Physician
  • Colorado Springs, CO
  • NPI 1316246515
  Medicare reassignment NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1629291893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 N UNION BLVD",
            "address_2": "SUITE 207",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207799",
            "telephone_number": "719-667-0888",
            "fax_number": "719-667-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 N UNION BLVD",
            "address_2": "SUITE 207",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207799",
            "telephone_number": "719-667-0888",
            "fax_number": "719-667-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "WHALEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNER",
        "authorized_official_telephone_number": "719-667-0888",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "33020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Chiropractic, PLLC
• Summit Counseling
• Summit Counseling Services, PLLC
• Summit Dental
• Summit Dental Care One (Summit Dental Care)
• Summit Hearing Aid Center
• Summit Home Health Care Inc
• Summit Integrated Health PLLC
• Summit Medical Clinic, PC
• Summit Nephrology PLLC

• Specialist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.