Active NPI
SB Dermatology PLLC
Doing business as Elite Dermatology Collective
- Nurse Practitioner
- Fayetteville, AR
National Provider Identifier
1629981790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- SB DERMATOLOGY PLLC
- Doing business as
- Elite Dermatology Collective
- Practice address
- 324 N College Ave RM 201
Fayetteville, AR 72701-4203 - Phone
- (479) 287-9978
- NPI assigned
- Sep 28, 2026
- Last updated
- Sep 28, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joseph Blackmon, MD
- Title
- Member
- Phone
- (479) 287-9978
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NU | Primary |
Addresses
Primary practice location
324 N College Ave RM 201
Fayetteville, AR 72701-4203
Mailing address
PO Box 8431
Fayetteville, AR 72703-0008
Phone (479) 287-9978
Other names 1
- Elite Dermatology Collective
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790553600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790553600000",
"number": "1629981790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8431",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727030008",
"telephone_number": "479-287-9978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 N COLLEGE AVE RM 201",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727014203",
"telephone_number": "479-287-9978"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SB DERMATOLOGY PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-28",
"last_updated": "2026-09-28",
"certification_date": "2026-09-27",
"status": "A",
"authorized_official_last_name": "BLACKMON",
"authorized_official_first_name": "JOSEPH",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "479-287-9978",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Elite Dermatology Collective",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.