ST CHARLES COUNTY DERMATOLOGIC SURGERY, LLC
NPI 1235761438
Dermatology - Procedural Dermatology in Cottleville, MO

NPI Status: Active since February 06, 2020

Contact Information

1493 COTTLEVILLE PKWY
COTTLEVILLE, MO
ZIP 63376
Phone: (636) 317-3376
Fax: (636) 244-1197

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  • Organization
  • Dermatology
  • Procedural Dermatology
  • CLIA Number: 26D2178225
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-08-2027

About ST CHARLES COUNTY DERMATOLOGIC SURGERY, LLC

This page provides the complete NPI Profile along with additional information for St Charles County Dermatologic Surgery, Llc, a provider established in Cottleville, Missouri operating as a Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1235761438 assigned on February 2020. The practitioner's primary taxonomy code is 207NS0135X. The provider is registered as an organization and their NPI record was last updated 6 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 authorized official of this NPI record is Stacey S Tull Md (Physician And Owner)

NPI
1235761438
Provider Name
ST CHARLES COUNTY DERMATOLOGIC SURGERY, LLC
Entity Type
Organization
Location Address
1493 COTTLEVILLE PKWY COTTLEVILLE, MO 63376
Location Phone
(636) 317-3376
Location Fax
(636) 244-1197
Mailing Address
1493 COTTLEVILLE PKWY COTTLEVILLE, MO 63376
Mailing Phone
(636) 317-3376
Mailing Fax
(636) 244-1197
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-06-2020
Last Update Date
02-06-2020
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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 Procedural Dermatology

Taxonomy Code
207NS0135X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

STACEY S TULL MD

Authorized Official Title
PHYSICIAN AND OWNER
Authorized Official Phone
(636) 327-3376

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
26D2178225
Facility Type
Physician Office
Certificate Effective Date
February 09, 2025
Certificate Expiration Date
February 08, 2027
Laboratory Director
STACEY S. TULL
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to St Charles County Dermatologic Surgery, Llc 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 1235761438, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
1
Doubled → 2
Pos 8
4
Unchanged
Pos 9
3
Doubled → 6
Check
8
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 3 → 6 7 → 14 → 5 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 1 + 4 + 6 + 2 + 4 + 6 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1235761438.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dermatology
1493 COTTLEVILLE PKWY
COTTLEVILLE, MO 63376
Physician Assistant
1493 COTTLEVILLE PKWY
SAINT PETERS, MO 63376

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235761438, enumerated as an "organization" on February 06, 2020.

The provider is located at 1493 COTTLEVILLE PKWY COTTLEVILLE, MO 63376 and the phone number is (636) 317-3376.

Dermatology with taxonomy code 207NS0135X and a focus in Procedural Dermatology.