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DERMATOLOGY AND MOHS SURGERY SKIN CANCER CENTER
NPI 1124763479
Dermatology in Branson, MO

Active since May 02, 2022CLIA Certified · 4 labs
110 BUSINESS PARK DR STE C, BRANSON, MO 65616(417) 336-0033(417) 239-0127 Get Directions Write a Review

NPPES record last updated: December 17, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 17, 2024, Oct 31, 2022, May 2, 2022 (3 updates tracked since 2022).

About Dermatology And Mohs Surgery Skin Cancer Center NPPES

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

DERMATOLOGY AND MOHS SURGERY SKIN CANCER CENTER (NPI 1124763479) is a healthcare organization registered as a dermatology in Branson, Missouri and active in the NPI registry since May 2022. The organization holds 4 active CLIA laboratory certificates, maintains 5 additional practice locations, and lists Adrienne Michele Schupbach, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1124763479
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY AND MOHS SURGERY SKIN CANCER CENTER
Location Address110 BUSINESS PARK DR STE CBranson, MO 65616-7449
Mailing Address110 Business Park Dr Ste CBranson, MO 65616-7449 · (417) 336-0033 · Fax (855) 710-6552
Phone(417) 336-0033
Fax(417) 239-0127
Organization SubpartNo
Authorized OfficialAdrienne Michele SchupbachOwner/physician · (309) 533-8899
Enumeration DateMay 2, 2022
Last NPPES UpdateDecember 17, 20243 updates tracked since enumeration
NPPES CertifiedDecember 17, 2024
✔ NPI 1124763479 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
110 BUSINESS PARK DR STE C, Branson, MO 65616
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Secondary Practice Locations 5

Location 12200 E Cleveland StMonett, MO 65708-6149 · Phone (417) 336-0033 · Fax (855) 710-6552
Location 21230 E Kingsley St Ste ASpringfield, MO 65804-7231 · Phone (417) 336-0033 · Fax (855) 710-6552
Location 310101 Stoltz DrRolla, MO 65401-7714 · Phone (417) 336-0033 · Fax (855) 710-6552
Location 4914 AlexisLebanon, MO 65536-6802 · Phone (417) 336-0033 · Fax (855) 710-6552
Location 5520 E 32nd StJoplin, MO 64804-3904 · Phone (417) 336-0033 · Fax (855) 710-6552

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dermatology And Mohs Surgery Skin Cancer Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Dermatology And Mohs Surgery Skin Cancer Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Douglas Leone, M.D.
Dermatology
NPI 1255523296
110 BUSINESS PARK DR STE C
Branson, MO 65616
(417) 336-0033
✔ PECOS✔ Accepts MedicareSame address
Rosa Nguyen, FNP
Nurse Practitioner
NPI 1437405248
1230 E KINGSLEY ST STE A&B
Springfield, MO 65804
(417) 336-0033
✔ PECOS✔ Accepts Medicare31 mi
Shawn Jackson, M,D,
Pathology
NPI 1730258708
1000 E PRIMROSE ST STE 550
Springfield, MO 65807
(417) 269-4646
✔ PECOS✔ Accepts Medicare31 mi
Adrienne Schupbach, M.D.
Dermatology
NPI 1740415777
3024 E EMPIRE ST STE E&F
Bloomington, IL 61704
(309) 451-3376
✔ PECOS✔ Accepts Medicare350 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 26D2012523

Dermatology And Mohs Surgery Skin Cancer Center Ll · Branson, MO
Active · expires Apr 25, 2027
CLIA Number26D2012523
Laboratory TypePhysician Office
Certificate Effective DateApril 26, 2025
Certificate Expiration DateApril 25, 2027
Laboratory DirectorAdrienne M. Schupbach
Laboratory Phone(417) 336-0033
Laboratory LocationDermatology And Mohs Surgery Skin Cancer Center Ll110 Business Park Drive Suite C, Branson, MO 65616
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 of Compliance 26D2313478

Dermatology And Mohs Surgery Skin Cancer Center · Lebanon, MO
Active · expires Mar 17, 2027
CLIA Number26D2313478
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2025
Certificate Expiration DateMarch 17, 2027
Laboratory DirectorAdrienne M. Schupbach
Laboratory Phone(417) 336-0033
Laboratory LocationDermatology And Mohs Surgery Skin Cancer Center914 Alexis Ave, Lebanon, MO 65536
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 of Compliance 26D2315043

Dermatology And Mohs Surgery Skin Cancer Center · Rolla, MO
Active · expires Feb 24, 2027
CLIA Number26D2315043
Laboratory TypePhysician Office
Certificate Effective DateFebruary 25, 2025
Certificate Expiration DateFebruary 24, 2027
Laboratory DirectorAdrienne M. Schupbach
Laboratory Phone(417) 336-0033
Laboratory LocationDermatology And Mohs Surgery Skin Cancer Center10101 Stoltz Dr, Rolla, MO 65401
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 of Compliance 26D2265865

Dermatology And Mohs Surgery Skin Cancer Center Ll · Springfield, MO
Active · expires May 23, 2027
CLIA Number26D2265865
Laboratory TypePhysician Office
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorAdrienne M. Schupbach
Laboratory Phone(417) 336-0033
Laboratory LocationDermatology And Mohs Surgery Skin Cancer Center Ll1230 E Kingsley Suite A, Springfield, MO 65804
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.

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 Dermatology And Mohs Surgery Skin Cancer Center's NPI number?

The NPI number for Dermatology And Mohs Surgery Skin Cancer Center is 1124763479. It was assigned to this organization in the NPPES registry on May 2, 2022.

Where is Dermatology And Mohs Surgery Skin Cancer Center located?

Dermatology And Mohs Surgery Skin Cancer Center is located at 110 Business Park Dr Ste C, Branson, MO 65616. The listed phone number is (417) 336-0033.

What is Dermatology And Mohs Surgery Skin Cancer Center's specialty?

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

Is Dermatology And Mohs Surgery Skin Cancer Center enrolled in Medicare?

Yes. Dermatology And Mohs Surgery Skin Cancer Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology And Mohs Surgery Skin Cancer Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Dermatology And Mohs Surgery Skin Cancer Center, in Dermatology, Nurse Practitioner and Pathology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology And Mohs Surgery Skin Cancer Center 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 Dermatology And Mohs Surgery Skin Cancer Center accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 4 other insurers list Dermatology And Mohs Surgery Skin Cancer Center 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 Dermatology And Mohs Surgery Skin Cancer Center was last updated on December 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.