DIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC
NPI 1215460290
Clinic/Center - Medical Specialty in Fort Collins, CO

Q: What is Divine Dermatology And Surgical Institute, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since April 06, 2017

1260 DOCTORS LN, FORT COLLINS, CO 80524(813) 765-8453 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 10, 2024, Sep 5, 2024 (2 updates tracked since 2024).

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About Divine Dermatology And Surgical Institute, Pllc NPPES

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

DIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC (NPI 1215460290) is a healthcare organization registered as a medical specialty in Fort Collins, Colorado and active in the NPI registry since April 2017. The organization lists Jennifer Divine, Owner, as its authorized official.

NPPES Registry Identity

NPI1215460290

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameDIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC

Location Address1260 DOCTORS LNFort Collins, CO 80524-4038

Mailing Address1260 Doctors Ln Ste AFort Collins, CO 80524-4072 · (970) 286-2668

Phone(813) 765-8453

Organization SubpartNo

Authorized OfficialJennifer DivineOwner · (970) 388-2850

Enumeration DateApril 6, 2017

Last NPPES UpdateSeptember 10, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 10, 2024

✔ NPI 1215460290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

License✔ Licensed in CO · DR.0058205

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

1260 DOCTORS LN, Fort Collins, CO 80524

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Other Providers at the Same Location NPPES 2

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

LAUREN GARLOCK

Physician Assistant (Medical)

1260 DOCTORS LN
FORT COLLINS, CO 80524

Larimer County (970) 286-2668

SAMANTHA SKELTON

Advanced Practice Midwife

1260 DOCTORS LN
FORT COLLINS, CO 80524

Larimer County (970) 493-1865

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 Divine Dermatology And Surgical Institute, PLLC's NPI number?

The NPI number for Divine Dermatology And Surgical Institute, PLLC is 1215460290. It was assigned to this organization in the NPPES registry on April 6, 2017.

Where is Divine Dermatology And Surgical Institute, PLLC located?

Divine Dermatology And Surgical Institute, PLLC is located at 1260 Doctors Ln, Fort Collins, CO 80524. The listed phone number is (813) 765-8453.

What is Divine Dermatology And Surgical Institute, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Divine Dermatology And Surgical Institute, PLLC was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.