Springville Dermatology & Diagnostics PC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

72474631204 Issued in UT

Legal business name

SPRINGVILLE DERMATOLOGY & DIAGNOSTICS PC

Practice address

732 N Main St
Springville, UT 84663-1034

Phone

(801) 704-7001

Fax

(801) 210-7012

NPI assigned

Jun 19, 2013

Last updated

Jun 18, 2025By 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

Michael Warren Peterson, DONPI 1770634909

Title

Owner/Physician

Phone

(801) 704-7001

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

Locations

Practitioners 14

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.

• Michael Warren Peterson, D.O.

  • Dermatology Physician
  • Spanish Fork, UT
  • NPI 1770634909
  Medicare reassignment Care Compare group NPD Authorized official
• James E Carly, PA-C

  • Medical Physician Assistant
  • Provo, UT
  • NPI 1316240575
  Medicare reassignment Care Compare group
• Scott Macdonald, PA-C

  • Physician Assistant
  • North Logan, UT
  • NPI 1720482086
  Medicare reassignment Care Compare group
• Brandon Shawn Mickelson, PA-C

  • Physician Assistant
  • Draper, UT
  • NPI 1790544534
  Medicare reassignment Care Compare group
• Damion D. Rodeback, PA-C

  • Physician Assistant
  • St George, UT
  • NPI 1083069793
  Medicare reassignment Care Compare group
• Kristine S Herlevi, PA-C

  • Physician Assistant
  • Henderson, NV
  • NPI 1720302680

  UT

  Medicare reassignment Care Compare group
• Michael Scott Robinson, FNP

  • Family Nurse Practitioner
  • Provo, UT
  • NPI 1437585155
  Medicare reassignment NPD
• Warren Albert Peterson, D.O.

  • Dermatology Physician
  • Spanish Fork, UT
  • NPI 1134198807
  NPD
• David G Dienhart, MD

  • Pulmonary Disease Physician
  • Murray, UT
  • NPI 1184601940
  NPD (past)
• Alan C Jones, D.O.

  • Otolaryngology Physician
  • Stansbury Park, UT
  • NPI 1598743973
  NPD (past)
• Patricia L Nelson, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Murray, UT
  • NPI 1629051206
  NPD (past)
• Sunny Pandita, MD

  • Pulmonary Disease Physician
  • Murray, UT
  • NPI 1023095809
  NPD (past)

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1992144364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 N MAIN ST",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846631034",
            "telephone_number": "801-704-7001",
            "fax_number": "801-210-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 N MAIN ST",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846631034",
            "telephone_number": "801-704-7001",
            "fax_number": "801-210-7012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1449 N 1400 W Ste 22",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847705237",
            "country_code": "US",
            "telephone_number": "435-703-9296",
            "fax_number": "435-215-4075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2321 N 400 E Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840743440",
            "country_code": "US",
            "telephone_number": "435-830-6110",
            "fax_number": "435-228-6769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2326 N 400 E",
            "address_2": "BLDG C Suite 202",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "84074",
            "country_code": "US",
            "telephone_number": "435-830-6110",
            "fax_number": "435-228-6769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 N University Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846042723",
            "country_code": "US",
            "telephone_number": "385-475-2116",
            "fax_number": "801-210-7012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 N University Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846042721",
            "country_code": "US",
            "telephone_number": "385-475-2116",
            "fax_number": "801-210-7012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRINGVILLE DERMATOLOGY & DIAGNOSTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "801-704-7001",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "UT",
            "license": "72474631204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Rachelle Sperle, MSW
• Alyssa Spjut, ACMHC-E
• Spring Canyon Therapy (Backcountry Balance)
• Springville City Corporation
• Springville Dentistry
• Springville Family Counseling Services (Brookside Family Counseling)
• Springville Oral Surgery PC
• Springville Oral Surgery PC
• Ralph Gordon Stapel Jr., CH
• Diane Starks, LCSW

• Dermatopathology Physician in Springville, UT
• Providers in Springville, UT by specialty
• Dermatopathology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.