NPIMap

Organization Active NPI

Guardian Dermatology

Doing business as Guardian Dermatology, PC

  • Dermatology Physician
  • Helena, MT
National Provider Identifier
1972172328
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
GUARDIAN DERMATOLOGY
Doing business as
Guardian Dermatology, PC
Practice address
40 W 14TH St Ste 3
Helena, MT 59601-3385
Phone
(406) 272-5941
NPI assigned
Jun 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Logan M Skelley, MDNPI 1851710727
Title
Member
Phone
(507) 327-1955

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

40 W 14TH St Ste 3
Helena, MT 59601-3385

Mailing address

40 W 14TH St Ste 3
Helena, MT 59601-3385
Phone (406) 272-5941

Other names 1

  • Guardian Dermatology, PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211206000684 MT Part B Supplier - Clinic/Group Practice 8820488968 Receives reassigned benefits from 4 practitioners
Practice locations: Helena, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1972172328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W 14TH ST STE 3",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013385",
            "telephone_number": "406-272-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W 14TH ST STE 3",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013385",
            "telephone_number": "406-272-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "SKELLEY",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "507-327-1955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guardian Dermatology, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.