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VIVIDA DERMATOLOGY
NPI 1053823120
Dermatology in St.george, UT

Active since October 30, 2017CLIA Certified · 4 labs
1490 E FOREMASTER DRIVE, SUITE 260, ST.GEORGE, UT 84790(435) 673-5373(702) 673-5041 Get Directions Write a Review

NPPES record last updated: May 9, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 9, 2018, Dec 18, 2017, Dec 1, 2017 and 1 more (4 updates tracked since 2017).

About Vivida Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIVIDA DERMATOLOGY (NPI 1053823120) is a healthcare organization registered as a dermatology in St.george, Utah and active in the NPI registry since October 2017. The organization holds 4 active CLIA laboratory certificates and lists Douglas F Fife, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1053823120
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameFIFE DERMATOLOGY UTAH
Location Address1490 E FOREMASTER DRIVE, SUITE 260St.george, UT 84790-4488
Mailing Address6460 Medical Center St Ste 350Las Vegas, NV 89148-2423 · (702) 255-6647 · Fax (702) 920-8444
Phone(435) 673-5373
Fax(702) 673-5041
Organization SubpartYesParent: Fife Dermatology, P.c.
Authorized OfficialDouglas F FifePresident/ceo · (702) 255-6647
Enumeration DateOctober 30, 2017
Last NPPES UpdateMay 9, 20184 updates tracked since enumeration
✔ NPI 1053823120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
1490 E FOREMASTER DRIVE, St.george, UT 84790
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Other Names 1

Doing Business AsVivida Dermatology

Other Identifiers 2

OtherCM808NV · Medicare
Other270773333NV · Tax-id

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 29D1105764

Vivida Dermatology-Sunset · Las Vegas, NV
Active · expires Feb 29, 2028
CLIA Number29D1105764
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2026
Certificate Expiration DateFebruary 29, 2028
Laboratory DirectorMac L. Machan
Laboratory Phone(702) 255-6647
Laboratory LocationVivida Dermatology-Sunset6460 Medical Center St Ste 350, Las Vegas, NV 89148
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 29D2168265

Vivida Dermatology (flamingo) · Las Vegas, NV
Active · expires Jun 24, 2027
CLIA Number29D2168265
Laboratory TypePhysician Office
Certificate Effective DateJune 25, 2025
Certificate Expiration DateJune 24, 2027
Laboratory DirectorDouglas J. Fife
Laboratory Phone(702) 255-6647
Laboratory LocationVivida Dermatology (flamingo)2110 E Flamingo Rd Ste 216, Las Vegas, NV 89119
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 29D2166555

Vivida Dermatology(henderson) · Henderson, NV
Active · expires Apr 1, 2027
CLIA Number29D2166555
Laboratory TypePhysician Office
Certificate Effective DateApril 2, 2025
Certificate Expiration DateApril 1, 2027
Laboratory DirectorMac L. Machan
Laboratory Phone(702) 255-6647
Laboratory LocationVivida Dermatology(henderson)1736 W Horizon Ridge Pkwy, Henderson, NV 89012
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 46D2146160

Vivida Dermatology · Saint George, UT
Active · expires Nov 13, 2026
CLIA Number46D2146160
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2024
Certificate Expiration DateNovember 13, 2026
Laboratory DirectorSteven D. Peine
Laboratory Phone(435) 673-5373
Laboratory LocationVivida Dermatology1490 E Foremaster Dr #150, Saint George, UT 84790
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ACTIVE LIFE PHYSICAL THERAPY AND INJURY CARE
Physical Therapist
1490 E FOREMASTER DRIVE, STE 260
ST. GEORGE, UT 84790
Washington County (435) 523-3378

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fife Dermatology Utah's NPI number?

The NPI number for Fife Dermatology Utah is 1053823120. It was assigned to this organization in the NPPES registry on October 30, 2017. The provider is doing business as Vivida Dermatology.

Where is Fife Dermatology Utah located?

Fife Dermatology Utah is located at 1490 E Foremaster Drive Suite 260, St.George, UT 84790. The listed phone number is (435) 673-5373.

What is Fife Dermatology Utah's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Fife Dermatology Utah hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Fife Dermatology Utah accept?

Health plans from Ambetter from Arizona Complete Health list Fife Dermatology Utah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fife Dermatology Utah was last updated on May 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.