CENTER FOR DERMATOLOGY, PLLC (NPI# 1194792416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194792416 |
| Entity Type | Organization |
| Organization Name | CENTER FOR DERMATOLOGY, PLLC |
| Other Organization Name | NORTH SCOTTSDALE DERMATOLOGY ASSOCIATES |
| Practice Address |
14275 N 87th St Suite 110 Scottsdale AZ 85260-3696 |
| Practice Telephone | 4809058485 |
| Practice Fax Number | 4809057274 |
| Mailing Telephone | 4809058485 |
| Mailing Fax Number | 4809057274 |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2019-11-07 |
| Authorized Official Name | DR. GARY ANTHONY MCCRACKEN (PRESIDENT) |
| Authorized Official Telephone | 4809058485 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
45164 | AZ | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
48145 | AZ | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 36909 | AZ | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| North Scottsdale Dermatology Associates | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11209 N Tatum Blvd Ste 175, Phoenix, AZ 850286016 | 4809058485 | |
| 520 Rose Ln, Wickenburg, AZ 853901447 | 4809058485 | |
| 3530 S Val Vista Dr Ste 109, Gilbert, AZ 852977319 | 4809058485 | |
| 1890 E Florence Blvd Ste 4, Casa Grande, AZ 851225642 | 4809058485 | |
| 18699 N 67th Ave Ste 220, Glendale, AZ 853087142 | 4809058485 | |
| 10440 E Riggs Rd Ste 160, Sun Lakes, AZ 852487757 | 4809058485 | |
| 16838 E Palisades Blvd Ste B124, Fountain Hills, AZ 852683789 | 4809058485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174062673 | Center for Dermatology, Pllc | Physician Assistant | 14275 N 87th St, Suite 109 & 110, Scottsdale, AZ 85260-3696 | 2017-02-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CENTER FOR DERMATOLOGY, PLLC | 14275 N 87th St Ste 109, Scottsdale, AZ 85260 |
| Oklahoma Business Registrations | CENTER FOR DERMATOLOGY, PLLC | 3915 E 31st St, Tulsa, OK 74135 |
| Street Address |
14275 N 87TH ST SUITE 110 |
| City | SCOTTSDALE |
| State | AZ |
| Zip Code | 85260-3696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538155320 | Kara Sue Gooding | Physician Assistant | 14275 N 87th St, Suite 110, Scottsdale, AZ 85260-3696 | 2005-09-27 |
| 1801336607 | Fiona Millie Blunt | Physician Assistant | 14275 N 87th St, Suite 109 & 110, Scottsdale, AZ 85260-3696 | 2017-02-28 |
| 1174062673 | Center for Dermatology, Pllc | Physician Assistant | 14275 N 87th St, Suite 109 & 110, Scottsdale, AZ 85260-3696 | 2017-02-16 |
| 1003243437 | David Daniel Feist | Physician Assistant | 14275 N 87th St, Ste 110, Scottsdale, AZ 85260-3696 | 2013-09-30 |
| 1295965119 | James Brian Young | Specialist | 14275 N 87th St, 110, Scottsdale, AZ 85260-3696 | 2009-07-27 |
| 1255578126 | Karin R Brimhall | Physician Assistant | 14275 N 87th St, Suite 110, Scottsdale, AZ 85260-3696 | 2009-01-14 |
| 1063668531 | Anthony John Petelin | Dermatology | 14275 N 87th St, Suite #110, Scottsdale, AZ 85260-3696 | 2008-08-15 |
| 1912160482 | Anthony Alan Nuara | Dermatology | 14275 N 87th St, Suite 110, Scottsdale, AZ 85260-3696 | 2008-07-05 |
| 1124201819 | Paul M Petelin Sr. | Dermatology | 14275 N 87th St, Ste 110, Scottsdale, AZ 85260-3696 | 2007-12-17 |
| 1629251004 | Clay Garrett Forsberg | Plastic Surgery | 14275 N 87th St, Suite 110, Scottsdale, AZ 85260-3696 | 2007-12-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153377 | Karen Lee Williams | Counselor | 7655 Eest Redfield Rd, Suite 4, Scottsdale, AZ 85260 | 2020-10-29 |
| 1477188001 | Dr. Lynne Remson, Stuttering Specialist, LLC | Clinic/Center | 7950 E. Acoma Dr., Ste 201, Scottsdale, AZ 85260 | 2020-03-04 |
| 1861049967 | Aca Wellness Institute | Registered Nurse | 10752 N. 89th Pl, 8, Ste 203, Scottsdale, AZ 85260 | 2019-08-22 |
| 1811542814 | Haven Home Physicians LLC | Internal Medicine | 15551 N Greenway-hayden Loop, Suite 155, Scottsdale, AZ 85260 | 2019-08-06 |
| 1700431079 | Corey Allen Niles | Physical Therapist | 16413 N 91st Street #c145, Scottsdale, AZ 85260 | 2019-08-05 |
| 1578126470 | Scottsdale Pediatric Dental Associates Inc | Dentist | 9280 E Raintree, Suite 108, Scottsdale, AZ 85260 | 2019-04-16 |
| 1548747645 | Oliver Canizales Renteria | Behavior Technician | 8310 East Cactus Road, Suite # 510, Scottsdale, AZ 85260 | 2018-07-23 |
| 1518454792 | Silent Night Sleep Center Lllp | Durable Medical Equipment & Medical Supplies | 9070 E Desert Cove Ave Ste 105, Scottsdale, AZ 85260 | 2018-04-13 |
| 1669976726 | Steincare Mobile Outpatient, LLC | Occupational Therapist | 9555 E. Raintree Drive, #2057, Scottsdale, AZ 85260 | 2018-03-22 |
| 1437658416 | Megan Anne Deffenbaugh | Behavior Technician | 8130 E Cactus Rd Suite 150, Scottsdale, AZ 85260 | 2018-02-06 |
| Find all providers in zip 85260 | ||||
| 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 |
|---|---|---|---|---|
| 1386133684 | Az Mobile Derm Inc | Dermatology | 6857 E Beverly Ln, Scottsdale, AZ 85254-1566 | 2018-05-02 |
| 1629438239 | Collaborative Skin Care Pllc | Dermatology | 20343 N Hayden Rd, Scottsdale, AZ 85255-3876 | 2016-02-25 |
| 1922484088 | Advanced Dermatology of Arizona, PC | Dermatology | 8817 E Bell Rd Ste 101, Scottsdale, AZ 85260-1589 | 2015-07-30 |
| 1235544479 | Jennifer Lynn Sawaya | Dermatology | 10900 N Scottsdale Rd Ste 202, Scottsdale, AZ 85254-5228 | 2014-06-26 |
| 1376975748 | Antiaging and Wellness Institute, Pllc | Dermatology | 4141 N Goldwater Blvd Ste 102, Scottsdale, AZ 85251-3848 | 2013-08-07 |
| 1447505755 | Christina L Kranc | Dermatology | 10200 N 92nd St Ste 205, Scottsdale, AZ 85258-4536 | 2012-07-24 |
| 1093081879 | Associates In Dermatology Care, Pllc | Dermatology | 11000 N Scottsdale Rd Ste 120, Scottsdale, AZ 85254-6169 | 2012-03-27 |
| 1184888364 | New Horizons Dermatology, PC | Dermatology | 3271 N Civic Center Plz Ste 5, Scottsdale, AZ 85251-6990 | 2008-07-16 |
| 1790983146 | Shelly A Friedman | Dermatology | 8800 East Raintree Dr, Suite 350, Scottsdale, AZ 85260-6709 | 2007-07-06 |
| 1699982611 | Shelly A Friedman | Dermatology | 8800 E Raintree Dr, Suite 350, Scottsdale, AZ 85260 | 2007-05-17 |
| Find all providers in SCOTTSDALE | ||||
| City | SCOTTSDALE |
| Zip Code | 85260 |
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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.