First Capitol Dermatology, L.L.C.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

R4P68

Legal business name

FIRST CAPITOL DERMATOLOGY, L.L.C.

Practice address

901 S. 5TH St.
First Capitol Dermatology, L.L.C.
St. Charles, MO 63301-2416

Phone

(636) 916-1300

Fax

(636) 916-1561

NPI assigned

Apr 3, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Henry W. Clever III, MDNPI 1518925312

Title

Physician/Owner

Phone

(636) 916-1300

Specialties & licenses 2

Addresses

Other identifiers 1

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 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Henry W Clever III, MD

  • MOHS-Micrographic Surgery Physician
  • Saint Charles, MO
  • NPI 1518925312
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine Glaser, M.D.

  • MOHS-Micrographic Surgery Physician
  • Hannibal, MO
  • NPI 1497100713

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ashley Elizabeth McGuinness, MD

  • MOHS-Micrographic Surgery Physician
  • Chesterfield, MO
  • NPI 1851882716
  Medicare reassignment Care Compare group NPD
• Courtney Erin Amin

  • Physician Assistant
  • Saint Louis, MO
  • NPI 1508273533
  Medicare reassignment Care Compare group
• Victoria Louise Cobb, N.P.

  • Family Nurse Practitioner
  • Saint Peters, MO
  • NPI 1386652055
  NPD

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1730352394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S. 5TH ST.",
            "address_2": "FIRST CAPITOL DERMATOLOGY, L.L.C.",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "633012416",
            "telephone_number": "636-916-1300",
            "fax_number": "636-916-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S. 5TH ST.",
            "address_2": "FIRST CAPITOL DERMATOLOGY, L.L.C.",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "633012416",
            "telephone_number": "636-916-1300",
            "fax_number": "636-916-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CAPITOL DERMATOLOGY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "CLEVER",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "636-916-1300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "R4P68",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": "R4P68",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203348628",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hillary Gardner Finch
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• Bev Fingerhood, M.D.
• Fink Chiropractic
• Matthew Gerard Fink, D.C.
• Jennifer Lynn Fischer, PLPC, ATR-P
• Melissa A Fischer, PMHNP-BC
• Krista Gerette Fisher, OTR/L
• Micheal Fisk
• Anna M Fitz-James, MD

• MOHS-Micrographic Surgery Physician in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• MOHS-Micrographic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.