Jeremy Glynn Light, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

2023049376 Issued in MO

Practice address

109 Pinehurst Dr
Branson, MO 65616-2796

Phone

(417) 888-0858

Fax

(417) 889-0476

NPI assigned

Mar 27, 2020

Last updated

Jul 9, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 7

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

University of Arkansas College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phelan Dermatology and AestheticsGroup PAC ID 9234538331, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.2 of 100Reported as group

Quality

71.6

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phelan Dermatology & Aesthetics

  • Dermatology Physician
  • Joplin, MO
  • NPI 1942881677
  Medicare reassignment Care Compare group NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1992746903
  Medicare reassignment NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1891179040
  Medicare reassignment
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Forefront Dermatology - Missouri, LLC

  dba Swann Dermatology Partners, A Forefront Dermatology Practice

  • Dermatology Physician
  • Branson, MO
  • NPI 1609791037
  NPD (past)
• Forefront Dermatology, S.C.

  dba Swann Dermatology Partners, A Forefront Dermatology Practice

  • Dermatology Physician
  • Branson, MO
  • NPI 1790638468
  NPD (past)
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1831727718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PINEHURST DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162796",
            "telephone_number": "417-888-0858",
            "fax_number": "417-889-0476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 E Cleveland St",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657086149",
            "country_code": "US",
            "telephone_number": "417-900-3407",
            "fax_number": "417-889-0476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "331 Hospital Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655369251",
            "country_code": "US",
            "telephone_number": "417-334-7200",
            "fax_number": "417-334-7299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1240 E Independence St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658044201",
            "country_code": "US",
            "telephone_number": "417-900-3407",
            "fax_number": "417-889-0476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 S National Ave Ste 705",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075239",
            "country_code": "US",
            "telephone_number": "417-900-3407",
            "fax_number": "417-889-0476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1240 E Independence St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658044201",
            "country_code": "US",
            "telephone_number": "417-900-3407",
            "fax_number": "417-889-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "JEREMY",
        "middle_name": "GLYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2023049376",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "2023049376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200098794",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeremy.Light@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1240 E Independence St Ste 100",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658044201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeremy.Light@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3850 S National Ave Ste 705",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658075239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "969 N Mason Rd",
            "address_2": "Div IM Dermatology, Ste 220",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeremy.Light@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2200 E Cleveland St",
            "city": "Monett",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657086149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeremy.Light@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "331 Hospital Dr Ste C",
            "city": "Lebanon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "655369251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeremy.Light@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "109 Pinehurst Dr",
            "city": "Branson",
            "state": "MO",
            "country_code": "US",
            "postal_code": "656162796",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeremy.Light@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1240 E Independence St Ste 200",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658044201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lester E. Cox Medical Centers
• Lester E. Cox Medical Centers (Coxhealth Center Branson)
• Jacob Dewayne Lewallen, DC
• Life Christian Outreach (Abiding Hope Home)
• Lifequest Support Services LLC
• Lincare Inc.
• Linkability, Inc.
• Donald M. Lippert, MD
• Jonathan David Liss
• Katrina Renee Lock, FNP

• MOHS-Micrographic Surgery Physician in Branson, MO
• Providers in Branson, 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 Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.