Dermatological Care, Inc.

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

Last updated

Jan 10, 2025By the provider in NPPES

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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 12

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.

• Anna Marie Aiazzi

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1417597923

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Caroline Victoria Anderson, FNP-C

  • Nurse Practitioner
  • Saint Louis, MO
  • NPI 1538998844
  Medicare reassignment Care Compare group NPD
• Regina Cruz Bowers, M.D.

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1467518589
  Medicare reassignment Care Compare group NPD
• Nikoleta Brankov, MD

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1427404102
  Medicare reassignment Care Compare group NPD
• Jessica Gruber, MD

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1295255115

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Brooke Noelle Shadel, MD, PHD, MPH

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1134327018
  Medicare reassignment Care Compare group NPD
• Daniel G Tinker, MD

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1417449869
  Medicare reassignment Care Compare group NPD
• Lawrence L Wang, M.D., PHD

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1376568980
  Medicare reassignment Care Compare group NPD
• Lindsay K Exline, PAC

  • Medical Physician Assistant
  • Saint Louis, MO
  • NPI 1427127109
  Medicare reassignment Care Compare group
• Omar W Jassim, MD, PHD

  • Dermatology Physician
  • Wentzville, MO
  • NPI 1649397415
  Medicare reassignment Care Compare group
• Deidre M. Brown, PA-C

  • Physician Assistant
  • Saint Louis, MO
  • NPI 1710303029
  Medicare reassignment
• Ian K Hornstra, MD

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1124044359
  Care Compare group

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": []
}

• Kristen Alice Derderian, CNP
• Jose Javier Derdoy, MD
• McKenzie Taylor Derennaux, RD, LD
• Nichole Leanne Derhake, PNP
• Derm-Care PC (Dr Elsa Gutierrez)
• Dermatology and Cutaneous Surgery, Inc
• Dermatology Associates, Inc.
• Dermatology Consultants, P.C. (Fred D. Bauschard, M.D.)
• Elizabeth Catherine Dermody
• Jennifer M Derner, LCSW

• Dermatology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dermatology Physician in Missouri

• 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.