NPIMap

Organization Active NPI

Alliance Health and Dermatology, LLC

  • Clinic/Center
  • Cape Girardeau, MO
National Provider Identifier
1952958449
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ALLIANCE HEALTH AND DERMATOLOGY, LLC
Practice address
304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920
Phone
(573) 803-3331
NPI assigned
Aug 20, 2019
Last updated
Mar 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Amanda Becker
Title
Office Manager
Phone
(573) 803-3331

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920

Mailing address

304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920
Phone (573) 803-3331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190910002484 MO Part B Supplier - Clinic/Group Practice 5597094961 Receives reassigned benefits from 11 practitioners
Practice locations: Cape Girardeau, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1952958449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034920",
            "telephone_number": "573-803-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034920",
            "telephone_number": "573-803-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE HEALTH AND DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-803-3331"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.