NPIMap

Organization Active NPI

Dermatology Specialists of Spokane

  • Dermatology Physician
  • Spokane, WA
National Provider Identifier
1912179599
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00023695 Issued in WA
Legal business name
DERMATOLOGY SPECIALISTS OF SPOKANE
Practice address
510 S Cowley St Ste 200
Spokane, WA 99202-1332
Phone
(509) 456-8444
Fax
(509) 455-9227
NPI assigned
Mar 24, 2008
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Julie P SchaubleNPI 1821185125
Title
Business Administrator
Phone
(509) 456-5949

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 Physician 207N00000X MD00023695 WA Primary

Addresses

Primary practice location

510 S Cowley St Ste 200
Spokane, WA 99202-1332

Mailing address

510 S Cowley St Ste 200
Spokane, WA 99202-1332
Phone (509) 456-8444

Other practice location 1

820 S McClellan St
Suite 426
Spokane, WA 99204-2457
Phone (509) 456-8444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080416000472 WA Part B Supplier - Clinic/Group Practice 2567540503 Receives reassigned benefits from 10 practitioners
Practice locations: Spokane, WA

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
50D0639299Dermatology Specialists of Spokane510 S Cowley St Suite 200, Spokane, WA 99202ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

Locations

510 S Cowley St
Ste 200
Spokane, WA 99202
Phone (509) 252-9191

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1912179599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S COWLEY ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021332",
            "telephone_number": "509-456-8444",
            "fax_number": "509-455-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S COWLEY ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021332",
            "telephone_number": "509-456-8444",
            "fax_number": "509-455-9227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 S McClellan St",
            "address_2": "Suite 426",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042457",
            "country_code": "US",
            "telephone_number": "509-456-8444",
            "fax_number": "509-455-9227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS OF SPOKANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "SCHAUBLE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "509-456-5949"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00023695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.