NPIMap

Organization Active NPI

Spokane Dermatology Clinic PS

  • Dermatology Physician
  • Spokane, WA
National Provider Identifier
1649367889
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SPOKANE DERMATOLOGY CLINIC PS
Practice address
324 S Sherman St
Suite A1
Spokane, WA 99202-1461
Phone
(509) 624-1184
Fax
(509) 625-1449
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Authorized official

Name
John Driscoll
Title
Administrator
Phone
(509) 624-1184

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

324 S Sherman St
Suite A1
Spokane, WA 99202-1461

Mailing address

324 S Sherman St
Suite A1
Spokane, WA 99202-1461
Phone (509) 624-1184

Other identifiers 1

IdentifierTypeStateIssuer
CE1737OtherWARAILROAD MEDICARE

Other names 1

  • William P Werschler MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040313000200 WA Part B Supplier - Clinic/Group Practice 9931098357 Receives reassigned benefits from 9 practitioners
Practice locations: Spokane, WA

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
50D0882332Spokane Dermatology Clinic324 S Sherman St, Spokane, WA 99202ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

Locations

105 W 8th Ave
Ste 250
Spokane, WA 99204
Phone (509) 464-6208

104 W 5th Ave
#330W
Spokane, WA 99204
Phone (509) 624-1184

324 S Sherman St
Spokane, WA 99202
Phone (509) 624-1184

324 S Sherman St
Ste A1
Spokane, WA 99202
Phone (509) 624-1184

Practitioners & affiliated clinicians

Practitioners 12

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": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1649367889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 S SHERMAN ST",
            "address_2": "SUITE A1",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021461",
            "telephone_number": "509-624-1184",
            "fax_number": "509-625-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 S SHERMAN ST",
            "address_2": "SUITE A1",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021461",
            "telephone_number": "509-624-1184",
            "fax_number": "509-625-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE DERMATOLOGY CLINIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "DRISCOLL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-624-1184"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE1737",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William P Werschler MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.