ADVANCED DESERT DERMATOLOGY
NPI 1003204975
Dermatology - Clinical & Laboratory Dermatological Immunology in Peoria, AZ
NPI Status: Active since December 31, 2014
Contact Information
9191 W THUNDERBIRD RD STE D101
PEORIA, AZ
ZIP 85381
Phone: (623) 977-6700
Fax: (623) 977-6771
- Organization
- Dermatology
- Clinical & Laboratory Dermatological Imm...
- CLIA Number: 03D1037447
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-29-2027
About ADVANCED DESERT DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Advanced Desert Dermatology, a provider established in Peoria, Arizona operating as a Dermatology, focusing in clinical & laboratory dermatological immunology . The healthcare provider is registered in the NPI registry with number 1003204975 assigned on December 2014. The practitioner's primary taxonomy code is 207NI0002X with license number 3535 (AZ). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Advanced Desert Dermatology. The authorized official of this NPI record is Shelly Mackey (Manager)
- NPI
- 1003204975
- Provider Legal Name
- VERNON T MACKEY, PC
- Other Organization Name
- ADVANCED DESERT DERMATOLOGY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 9191 W THUNDERBIRD RD STE D101 PEORIA, AZ 85381
- Location Phone
- (623) 977-6700
- Location Fax
- (623) 977-6771
- Mailing Address
- 9191 W THUNDERBIRD RD STE D101 PEORIA, AZ 85381
- Mailing Phone
- (623) 977-6700
- Mailing Fax
- (623) 977-6771
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-31-2014
- Last Update Date
- 12-31-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology Clinical & Laboratory Dermatological Immunology
- Taxonomy Code
- 207NI0002X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 3535
- License State
- AZ
- Taxonomy Description
- A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D1037447
- Facility Type
- Physician Office
- Certificate Effective Date
- September 30, 2025
- Certificate Expiration Date
- September 29, 2027
- Laboratory Director
- BRANDON J. MACKEY
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Advanced Desert Dermatology after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003204975, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
PEORIA, AZ 85381
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003204975, enumerated as an "organization" on December 31, 2014.
The provider is located at 9191 W THUNDERBIRD RD STE D101 PEORIA, AZ 85381 and the phone number is (623) 977-6700.
Dermatology with taxonomy code 207NI0002X and a focus in Clinical & Laboratory Dermatological Immunology.
