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NORTH VALLEY DERMATOLOGY LLC
NPI 1184600884
Dermatology in Peoria, AZ

Active since December 15, 2005CLIA 03D0530924 · Certificate of Compliance
14155 N 83RD AVE, SUITE 110, PEORIA, AZ 85381(623) 215-0911(623) 215-0912 Get Directions Write a Review

NPPES record last updated: September 12, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About North Valley Dermatology Llc NPPES

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

NORTH VALLEY DERMATOLOGY LLC (NPI 1184600884) is a healthcare organization registered as a dermatology in Peoria, Arizona and active in the NPI registry since December 2005. The organization holds a CLIA Certificate of Compliance certificate valid through November 29, 2026 and lists Mary F Fredenberg, Owner, as its authorized official.

NPPES Registry Identity

NPI1184600884
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNORTH VALLEY DERMATOLOGY LLC
Location Address14155 N 83RD AVE, SUITE 110Peoria, AZ 85381-5639
Mailing Address14155 N 83rd Ave, Suite 110Peoria, AZ 85381-5639 · (623) 215-0911 · Fax (623) 215-0912
Phone(623) 215-0911
Fax(623) 215-0912
Organization SubpartNo
Authorized OfficialMary F FredenbergOwner · (623) 215-0911
Enumeration DateDecember 15, 2005
Last NPPES UpdateSeptember 12, 2011
✔ NPI 1184600884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in AZ · 16095
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.
14155 N 83RD AVE, Peoria, AZ 85381
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Other Identifiers 1

Medicare UPINZ66036AZ

Group Practice 1

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

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 03D0530924

Southwest Skin Specialists, LLC Dba North Valley Dermatology · Peoria, AZ
Active · expires Nov 29, 2026
CLIA Number03D0530924
Laboratory TypePhysician Office
Certificate Effective DateNovember 30, 2024
Certificate Expiration DateNovember 29, 2026
Laboratory DirectorAjdin Kobic
Laboratory Phone(623) 215-0911
Laboratory LocationSouthwest Skin Specialists, LLC Dba North Valley Dermatology14155 N 83rd Ave Ste 110, Peoria, AZ 85381
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.

Other Providers at the Same Location NPPES 20

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

DR. AKSHAY VIJAY SHAH M.D.
Internal Medicine (Gastroenterology)
14155 N 83RD AVE, SUITE 122
PEORIA, AZ 85381
Maricopa County (623) 773-1161
LISA MARY GREENAN PA-C
Physician Assistant
14155 N 83RD AVE, SUITE #110
PEORIA, AZ 85381
Maricopa County (623) 215-0911
OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST PA
Clinic/Center (Occupational Medicine)
14155 N 83RD AVE, BUILDING 8, SUITE 148
PEORIA, AZ 85381
Maricopa County (623) 487-8598
MARY F FREDENBERG MD
Dermatology
14155 N 83RD AVE, SUITE #110
PEORIA, AZ 85381
Maricopa County (623) 215-0911
MISS TERRI L PAYNE FNP-C
Nurse Practitioner (Family)
14155 N 83RD AVE
PEORIA, AZ 85381
Maricopa County (623) 271-8666
DALJIT S BAL MD
Internal Medicine (Gastroenterology)
14155 N 83RD AVE, STE 122
PEORIA, AZ 85381
Maricopa County (623) 773-1161
MICHAEL THOMAS MORGAN D.P.T.
Physical Therapist
14155 N 83RD AVE, #148
PEORIA, AZ 85381
Maricopa County (623) 487-8598
RACHELLE ELIZABETH UNDERHILL P.T.
Physical Therapist
14155 N 83RD AVE, BLDG. 8, SUITE 148
PEORIA, AZ 85381
Maricopa County (623) 487-8647

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 North Valley Dermatology LLC's NPI number?

The NPI number for North Valley Dermatology LLC is 1184600884. It was assigned to this organization in the NPPES registry on December 15, 2005.

Where is North Valley Dermatology LLC located?

North Valley Dermatology LLC is located at 14155 N 83rd Ave Suite 110, Peoria, AZ 85381. The listed phone number is (623) 215-0911.

What is North Valley Dermatology LLC's specialty?

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

Does North Valley Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 03D0530924) is associated with this NPI, valid through November 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does North Valley Dermatology LLC accept?

Health plans from Ambetter from Arizona Complete Health list North Valley Dermatology LLC 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 North Valley Dermatology LLC was last updated on September 12, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.