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ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC
NPI 1245426162
Clinic/Center in Fayetteville, AR

Active since September 25, 2007CLIA Certified · 4 labs
1444 E STEARNS ST, SUITE 11, FAYETTEVILLE, AR 72703(479) 718-7546(479) 966-4979 Get Directions Write a Review

NPPES record last updated: August 2, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Advanced Dermatology & Skin Cancer Center, Llc NPPES

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

ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC (NPI 1245426162) is a healthcare organization registered as a clinic/center in Fayetteville, Arkansas and active in the NPI registry since September 2007. The organization holds 4 active CLIA laboratory certificates and lists Lance Brandon Henry, Director, as its authorized official.

NPPES Registry Identity

NPI1245426162
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC
Location Address1444 E STEARNS ST, SUITE 11Fayetteville, AR 72703-6243
Mailing Address1444 E Stearns St, Suite 11Fayetteville, AR 72703-6243 · (479) 718-7546 · Fax (479) 966-4979
Phone(479) 718-7546
Fax(479) 966-4979
Organization SubpartNo
Authorized OfficialLance Brandon HenryDirector · (479) 856-8494
Enumeration DateSeptember 25, 2007
Last NPPES UpdateAugust 2, 2021
NPPES CertifiedAugust 2, 2021
✔ NPI 1245426162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1444 E STEARNS ST, Fayetteville, AR 72703
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan 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)

Advanced Dermatology & Skin Cancer Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Advanced Dermatology & Skin Cancer Center, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Lance Henry, M.D.
Dermatology
NPI 1679682520
1444 E STEARNS ST SUITE 11
Fayetteville, AR 72703
(479) 718-7546
✔ PECOS✔ Accepts MedicareSame address
Lyndsey Whitaker, APRN
Nurse Practitioner
NPI 1295292332
4375 N VANTAGE DR STE 305
Fayetteville, AR 72703
(479) 443-5100
✔ PECOS✔ Accepts Medicare0.5 mi
Ryan Rich, MD
Dermatology
NPI 1578852455
1001 S 52ND ST
Rogers, AR 72758
(479) 718-7546
✔ PECOS✔ Accepts Medicare14 mi
Cyril Severns, MD
Dermatology
NPI 1013904176
7900 DALLAS ST
Fort Smith, AR 72903
(479) 242-6647
✔ PECOS54 mi
Mark Naylor, MD
Dermatology
NPI 1518916386
4107 S WATER TOWER PL
Mount Vernon, IL 62864
(618) 244-0031
✔ PECOS324 mi
Nathan Johnson, M.D.
Dermatology
NPI 1942731674
1 RIVERSIDE CIR STE 300
Roanoke, VA 24016
(540) 224-5170
✔ PECOS✔ Accepts Medicare791 mi
Seth Martin
Micrographic Dermatologic Surgery (MDS)
NPI 1801355862
424 LILLY RD NE
Olympia, WA 98506
(360) 459-1700
✔ PECOS✔ Accepts Medicare

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 04D1094440

Advanced Dermatology & Skin Cancer Center · Fayetteville, AR
Active · expires May 4, 2028
CLIA Number04D1094440
Laboratory TypePhysician Office
Certificate Effective DateMay 5, 2026
Certificate Expiration DateMay 4, 2028
Laboratory DirectorDr. Lance B. Henry
Laboratory Phone(479) 718-7546
Laboratory LocationAdvanced Dermatology & Skin Cancer Center1444 E Stearns St, Suite 11, Fayetteville, AR 72703
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) 04D2081659

Advanced Dermatology & Skin Cancer Center · Bentonville, AR
Active · expires Jun 23, 2028
CLIA Number04D2081659
Laboratory TypePhysician Office
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorDr. Henry B. Lance
Laboratory Phone(479) 718-7546
Laboratory LocationAdvanced Dermatology & Skin Cancer Center701 NW Mcnelly Rd, Bentonville, AR 72712
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 for Provider-Performed Microscopy Procedures (PPMP) 04D2154565

Advanced Dermatology & Skin Cancer Center · Harrison, AR
Active · expires Jul 14, 2027
CLIA Number04D2154565
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2025
Certificate Expiration DateJuly 14, 2027
Laboratory DirectorDr. Henry B. Lance
Laboratory Phone(479) 718-7546
Laboratory LocationAdvanced Dermatology & Skin Cancer Center1324 North Hwy 62/65 Sierra Center, Suite C2, Harrison, AR 72601
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 04D2287758

Advanced Dermatology And Skin Cancer Center · Rogers, AR
Active · expires Jun 22, 2027
CLIA Number04D2287758
Laboratory TypePhysician Office
Certificate Effective DateJune 23, 2025
Certificate Expiration DateJune 22, 2027
Laboratory DirectorDr. Lance B. Henry
Laboratory Phone(479) 718-7546
Laboratory LocationAdvanced Dermatology And Skin Cancer Center1001 S 52nd Street Ste 108, Rogers, AR 72758
CLIA data matches this NPI record on: 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 Advanced Dermatology & Skin Cancer Center, LLC's NPI number?

The NPI number for Advanced Dermatology & Skin Cancer Center, LLC is 1245426162. It was assigned to this organization in the NPPES registry on September 25, 2007.

Where is Advanced Dermatology & Skin Cancer Center, LLC located?

Advanced Dermatology & Skin Cancer Center, LLC is located at 1444 E Stearns St Suite 11, Fayetteville, AR 72703. The listed phone number is (479) 718-7546.

What is Advanced Dermatology & Skin Cancer Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Advanced Dermatology & Skin Cancer Center, LLC enrolled in Medicare?

Yes. Advanced Dermatology & Skin Cancer Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Dermatology & Skin Cancer Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Advanced Dermatology & Skin Cancer Center, LLC. 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. The largest specialties are Dermatology (5), Micrographic Dermatologic Surgery (MDS) (1) and Nurse Practitioner (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advanced Dermatology & Skin Cancer Center, LLC 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 Advanced Dermatology & Skin Cancer Center, LLC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Advanced Dermatology & Skin Cancer Center, 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 Advanced Dermatology & Skin Cancer Center, LLC was last updated on August 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.