Bondurant Dermatology, PLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BONDURANT DERMATOLOGY, PLC

Practice address

88 Paine Cir Ste 4
Bondurant, IA 50035-1449

Phone

(515) 348-6383

Fax

(515) 348-6437

NPI assigned

Aug 7, 2024

Last updated

Nov 20, 2024By 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

Susan Peden, ARNPNPI 1356834113

Title

Owner

Phone

(515) 205-4571

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

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.

• Susan L Peden, ARNP

  • Dermatology Physician
  • Bondurant, IA
  • NPI 1356834113

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1902636558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 PAINE CIR STE 4",
            "city": "BONDURANT",
            "state": "IA",
            "postal_code": "500351449",
            "telephone_number": "515-348-6383",
            "fax_number": "515-348-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 PAINE CIR STE 4",
            "city": "BONDURANT",
            "state": "IA",
            "postal_code": "500351449",
            "telephone_number": "515-348-6383",
            "fax_number": "515-348-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONDURANT DERMATOLOGY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "PEDEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-205-4571",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyssa Rae Angle McGinnis, LMHC
• Diane Lynn Backous
• Crystal Berkenes
• Bloom Into You Counseling LLC
• Bondurant Dental Center (Bondurant Family Dentistry)
• Bondurant Family Chiropractic, PC
• Bondurant Physical Therapy LLC
• Bondurant Psychiatry
• Bondurant-Farrar Community School
• Carissa Bowie

• Dermatology Physician in Bondurant, IA
• Providers in Bondurant, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.