NPIMap

Organization Active NPI

Dermatological Care, Inc.

  • Dermatology Physician
  • Saint Louis, MO
National Provider Identifier
1720005770
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
34703 Issued in MO
Legal business name
DERMATOLOGICAL CARE, INC.
Practice address
12200 Weber Hill Rd Ste 200
Saint Louis, MO 63127-1569
Phone
(314) 842-5660
Fax
(314) 842-0169
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Nancy Marchi
Title
Office Manager
Phone
(314) 842-5660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 34703 MO Primary

Addresses

Primary practice location

12200 Weber Hill Rd Ste 200
Saint Louis, MO 63127-1569

Mailing address

10004 Kennerly Rd
395B
Saint Louis, MO 63128-2141
Phone (314) 842-5660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603001137 MO Part B Supplier - Clinic/Group Practice 1153303011 Receives reassigned benefits from 11 practitioners
Practice locations: Saint Louis, MO

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
26D0439869Dermatological Care Inc12200 Weber Hill Rd, Ste 200, Saint Louis, MO 63127Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

12200 Weber Hill Rd
Ste 200
Saint Louis, MO 63127
Phone (314) 842-5660

10012 Kennerly Rd
Ste 401
Saint Louis, MO 63128
Phone (314) 842-5660

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": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1720005770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "395B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-5660",
            "fax_number": "314-842-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WEBER HILL RD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271569",
            "telephone_number": "314-842-5660",
            "fax_number": "314-842-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "MARCHI",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-842-5660"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MO",
            "license": "34703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.