BLUE VALLEY DERMATOLOGY (NPI# 1104354794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104354794 |
| Entity Type | Organization |
| Organization Name | BLUE VALLEY DERMATOLOGY |
| Practice Address |
7840 W 165th Street Suite 260 Overland Park KS 66223 |
| Practice Telephone | 4158021310 |
| Mailing Telephone | 4158021310 |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | TOM TKACHUK (MANAGER) |
| Authorized Official Telephone | 4158021310 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 04-36968 | KS | Allopathic & Osteopathic Physicians |
| Street Address |
7840 W 165TH STREET SUITE 260 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205313566 | Midwest Orthopedic Network Kansas | Neuromusculoskeletal Medicine, Sports Medicine | 6500 W 143rd Street, Overland Park, KS 66223 | 2018-07-19 |
| 1073018446 | Davidson Family Chiropractic LLC | Chiropractor | 7951 West 160th Street, Suite 500, Overland Park, KS 66223 | 2018-03-28 |
| 1417495797 | Eye Associates of South Overland Park | Optometrist | 8029 W 159th St., Overland Park, KS 66223 | 2017-02-07 |
| 1255876652 | Shawnee Mission Medical Center Inc | General Acute Care Hospital | 7820 W 165th Street, Overland Park, KS 66223 | 2016-12-21 |
| 1679921902 | Jake Westley Davidson | Chiropractor | 7951 W 160th Street, Suite 500, Overland Park, KS 66223 | 2016-05-26 |
| 1356709281 | Peak Health, LLC | Physical Medicine & Rehabilitation | 7555 W 150th St Ste A, Overland Park, KS 66223 | 2016-02-06 |
| 1881068179 | Jalaleddin Zakeri | Chiropractor | 7504 W 156 St, Overland Park, KS 66223 | 2015-11-24 |
| 1972999688 | Karen Gell | Pharmacy Technician | 8101 West 151st Street, Overland Park, KS 66223 | 2015-04-09 |
| 1861812869 | Acute Spinal Rehab Pa | Chiropractor | 7555 W 150th Street, Overland Park, KS 66223 | 2014-04-17 |
| 1588932339 | Leonard B Sapp | Pharmacist | 8681 W 137th St, Overland Park, KS 66223 | 2011-12-08 |
| Find all providers in zip 66223 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710444500 | Epiphany Dermatology of Kansas, LLC | Dermatology | 10600 Quivira Rd Ste 430, Overland Park, KS 66215-2312 | 2019-02-27 |
| 1295072163 | Bernard James Melia Jr. | Dermatology | 5418 W 100th St, Overland Park, KS 66207-3116 | 2013-01-11 |
| 1760709679 | Lauren Ann Kyle Tkachuk | Dermatology | 7840 W 165th St Ste 260, Overland Park, KS 66223-3020 | 2010-05-02 |
| 1609966753 | Adult and Pediatric Dermatology | Dermatology | 4601 W. 109th Street, Suite 116, Overland Park, KS 66211-1313 | 2006-10-12 |
| 1780062901 | Emilie Dore Badje | Dermatology | 10777 Nall Ave Ste 220, Overland Park, KS 66211 | 2015-05-07 |
| 1376807917 | Matthew C. Fink | Dermatology | 4061 Indian Creek Pkwy, Overland Park, KS 66207-4030 | 2012-06-28 |
| 1619264595 | Megan Phillips Lent | Dermatology | 7901 W 135th St, Overland Park, KS 66223-1201 | 2011-06-29 |
| 1376786780 | Rebecca Leigh Chain | Dermatology | 10777 Nall Ave Ste 220, Overland Park, KS 66211-1359 | 2009-04-15 |
| 1295994895 | Jeffery Justin Graves | Dermatology | 7901 W 135th St, Overland Park, KS 66223 | 2008-06-09 |
| 1689841025 | Thomas Lewis Hamaguchi Hocker | Dermatology | 6901 W 121st St, Overland Park, KS 66209-2007 | 2008-05-14 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66223 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.