Organization Active NPI

Hightower Dermatology Services, LLC

  • Dermatology Physician
  • Sun City Center, FL
National Provider Identifier
1740620178
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME 95249 Issued in FL
Legal business name
HIGHTOWER DERMATOLOGY SERVICES, LLC
Practice address
957 E del Webb Blvd
Suite 101
Sun City Center, FL 33573-6671
Phone
(813) 634-1484
Fax
(813) 435-2023
NPI assigned
Jun 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Kortney D Hightower, MDNPI 1437181559
Title
President
Phone
(813) 634-1484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME 95249 FL Primary

Addresses

Primary practice location

957 E del Webb Blvd
Suite 101
Sun City Center, FL 33573-6671

Mailing address

957 E del Webb Blvd
Suite 101
Sun City Center, FL 33573-6671
Phone (813) 634-1484

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130819000156 FL Part B Supplier - Clinic/Group Practice 7315189578 Receives reassigned benefits from 5 practitioners
Practice locations: Sun City Center, FL

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
10D2167996Hightower Dermatology957 E del Webb Blvd Ste 101, Sun City Center, FL 33573ComplianceOct 1, 2027

National Provider Directory

National Provider Directory

Locations

957 E Del Webb Blvd
Ste 101
Sun City Ctr, FL 33573
Phone (813) 634-1484

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7320/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1372464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1740620178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 E DEL WEBB BLVD",
            "address_2": "SUITE 101",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736671",
            "telephone_number": "813-634-1484",
            "fax_number": "813-435-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 E DEL WEBB BLVD",
            "address_2": "SUITE 101",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736671",
            "telephone_number": "813-634-1484",
            "fax_number": "813-435-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHTOWER DERMATOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-29",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "KORTNEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-634-1484",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME 95249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.