Great Plains Dermatology, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0523958 Issued in KS

Legal business name

GREAT PLAINS DERMATOLOGY, P.A.

Practice address

2708 Sternberg Dr
Hays, KS 67601-1922

Phone

(785) 625-7546

Fax

(785) 625-7598

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Donald Kenneth Tillman Jr., D.O.NPI 1821198037

Title

President

Phone

(785) 625-7546

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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 4

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

• Donald Kenneth Tillman Jr., D.O.

  • Dermatology Physician
  • Hays, KS
  • NPI 1821198037
  Medicare reassignment Care Compare group NPD Authorized official
• Julie Ann Brull, ARNP-C

  • Nurse Practitioner
  • Hays, KS
  • NPI 1538278429
  Medicare reassignment Care Compare group NPD
• Nicole Hibbs, D.O.

  • Dermatology Physician
  • Hays, KS
  • NPI 1871937250
  Medicare reassignment Care Compare group NPD
• Madysen Weigel, APRN

  • Nurse Practitioner
  • Hays, KS
  • NPI 1295492908
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1740380963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 STERNBERG DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "67601",
            "telephone_number": "785-625-7546",
            "fax_number": "785-625-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 STERNBERG DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676011922",
            "telephone_number": "785-625-7546",
            "fax_number": "785-625-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT PLAINS DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-625-7546",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "KS",
            "license": "0523958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meganne Gourley, PA-C, ATC
• Carl Edward Grahs, EDD
• Amanda Gray
• Kayla Gray, DO
• Great Plains Chiropractic, LLC
• Keith Green, M.D.
• Greenleaf Nutrition Consulting LLC
• Pamela J Greenleaf, MS, RD, LD
• Dawn M. Gregory, M.S.ED., LCPC
• Alex Moran Grieves, D.V.M.

• Dermatology Physician in Hays, KS
• Providers in Hays, KS by specialty
• Dermatology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.