Pure Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PURE DERMATOLOGY LLC

Practice address

466 E 500 S
Salt Lake City, UT 84111-3342

Phone

(801) 475-3090

NPI assigned

Jan 24, 2024

Last updated

Jan 24, 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

Lea Hedstrom, PANPI 1952656738

Title

Owner

Phone

(801) 475-3090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00334

Practitioners 9

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.

• Lea D Hedstrom, PA-C

  • Physician Assistant
  • Ogden, UT
  • NPI 1952656738
  Medicare reassignment Authorized official
• Navdeep Singh Brar, DC

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1477270023
  NPD
• Dustin James Hedstrom, D.C.

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1831383298
  NPD
• Rebekah Patton, DC

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1326882812
  NPD
• Carter Blackham

  • Physical Therapist
  • Herriman, UT
  • NPI 1932521986
  NPD (past)
• John Corbaley, D.C.

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1962814392
  NPD (past)
• James Farthing Leonard, DC

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1740789890

  Single Specialty

  NPD (past)
• Zachary Taylor, D.C.

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1124485123
  NPD (past)
• Liana Marie Allen, LAC, MACOM

  • Acupuncturist
  • Portland, OR
  • NPI 1396252458
  NPD (past)

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1902668171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 E 500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113342",
            "telephone_number": "801-475-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 E 500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113342",
            "telephone_number": "801-475-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "HEDSTROM",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-475-3090",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda L. Purcell, MD
• Nancy Purcell, NP
• Johanna Carolina Purdy, MD
• Phylicia Purdy, FNP
• Pure Balance Cancer Support
• Pure Infusion Suites, LLC
• Jessica Dawn Purkey, RN
• Courtney Anne Pursell, PHARMD
• Dean Purser
• Rebecca Jane Purtell, M.D.

• Dermatology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.